Privatization Of Health Services Research Articles

THE RISE OF PRIVATIZATION IN HEALTH SECTOR: EXPLORING THE RELATIONSHIP BETWEEN PRIVATE HEALTH CARE AND THE UPPER CLASS

In the past twenty years, the transfer of health care services from public to private ownership has been a topic of significant interest in almost every country worldwide. Privatization and the free-market system have become attractive options for countries dealing with rising healthcare costs, growing dissatisfaction with the effectiveness and quality of care in public health facilities, and limited public resources to support healthcare services. The purpose of the research to explore the relationship between private health care and the upper class. The study identifies the causes of privatization, including globalization, modernization, urbanization, capitalism, neoliberal policy formation, and people's access to it. This study is based on primary data. In order to collect primary data, a comprehensive study questionnaire was designed, including both structured closed-ended and open-ended questions, and data have been collected randomly from ten private hospitals in Madaripur. The research included a sample size of 130 respondents, consisting of 110 patients, 20 nurses, and hospital authorities. The findings conclude that private health care is the outcome of elites’ demand, which is decorated with advanced facilities. In a public hospital, it is impossible for a patient to anticipate a simple pathological or radiological examination. Patients ultimately find themselves compelled to visit private clinics. However, the high cost of these clinics often restricts people's access to them. Aside from this, capitalism has given birth to private ownership and class categorization in society, while neoliberal policy has reduced government control over public expenditure. Market competition, individual responsibility, consumer choice, and lifestyle change have also increased the privatization of health services in Madaripur, as well as in the larger cities of Bangladesh. KEYWORDS: privatization, health care, globalization, capitalism, public health, neoliberal policy

Exploring the consequences of decentralization: has privatization of health services been the perceived effect of decentralization in Khartoum locality, Sudan?

BackgroundThe health system of Sudan has experienced several forms of decentralization, as well as, a radical reform. Authority and governance of secondary and tertiary health facilities have been shifted from federal to state levels. Moreover, the provision of health care services have been moved from large federal tertiary level hospitals such as Khartoum Teaching Hospital (KTH) and Jafaar Ibnoaf Hospital (JIH), located in the center of Khartoum, to smaller district secondary hospitals like Ibrahim Malik (IBMH), which is located in the southern part of Khartoum. Exploring stakeholders’ perceptions on this decentralisation implementation and its relevant consequences is vital in building an empirical benchmark for the improvement of health systems.MethodsThis study utilised a qualitative design which is comprised of in-depth interviews and qualitative content analysis with an inductive approach. The study was conducted between July and December 2015, and aimed at understanding the personal experiences and perceptions of stakeholders towards decentralisation enforcement and the implications on public health services, with a particular focus on the Khartoum locality. It involved community members residing in the Khartoum Locality, specifically in catchments area where hospital decentralisation was implemented, as well as, affiliated health workers and policymakers.ResultsThe major finding suggested that privatisation of health services occurred after decentralisation. The study participants also highlighted that scrutiny and reduction of budgets allocated to health services led to an instantaneous enforcement of cost recovery user fee.Devolving KTH Khartoum Teaching and Jafar Ibnoaf Hospitals into peripherals with less. Capacity, was considered to be a plan to weaken public health services and outsource services to private sector. Another theme that was highlighted in hospitals included the profit-making aspect of the governmental sector in the form of drug supplying and profit-making retail.ConclusionsA change in health services after the enforcement of decentralisation was illustrated. Moreover, the incapacitation of public health systems and empowerment of the privatisation concept was the prevailing perception among stakeholders. Having contextualised in-depth studies and policy analysis in line with the global liberalisation and adjustment programmes is crucial for any health sector reform in Sudan.

The Consequences of Neoliberalism in the Current Pandemic.

This article analyzes how the neoliberal policies, such as the politics of austerity (with considerable cuts to social policy expenditures including medical care and public health services) and the privatization of health services, imposed by many governments on both sides of the North Atlantic, considerably weakened the capacity of the response to the coronavirus pandemic in Italy, Spain, and the United States.

We Need Strong Public Health Care to Contain the Global Corona Pandemic.

The corona virus (COVID-19) outbreak has spread from China to over a hundred countries in less than 2 months. Now is the time to take stock and to assess the responses of different countries to the outbreak so far. What we can learn from the global Corona pandemic so far is that strong public health systems have the resilience to address massive health threats with the collective responses they require. Privatization of health services and individualization of risks might further undermine our ability to address this and future global pandemics.

A difusão da telemedicina em Portugal: dos benefícios prometidos aos riscos de um sistema de cuidados duas velocidades

O objetivo primário deste artigo é analisar a política de implementação da telemedicina, à luz das possíveis repercussões que a sua difusão pode induzir, quer na prática médica quotidiana, quer, mais em geral, na organização do SNS. A análise baseia-se em dados secundários obtidos a partir de atos normativos e relatórios publicados pelo Ministério da Saúde e pela Comissão Europeia, tanto no âmbito específico da e-Health, quanto naquele mais abrangente da inovação tecnológica em saúde. Após avaliar os principais eixos da estratégia pública de promoção da telemedicina, realçamos a necessidade de uma visão crítica que acompanhe a difusão dos serviços à distância na prática médica, a fim de evitar repercussões negativas, entre as quais o aumento da tendência de privatização dos serviços de saúde e o agravamento das desigualdades, com o risco inerente de criar um sistema de cuidados de saúde “a duas velocidades”.

Workshop: Everything you always wanted to know about EU health policy but were afraid to ask

Abstract Objective The EU is often criticized for being ‘market-driven’ and practicing a form of ‘cold integration’. Any attempt, however, to strengthen solidarity and social integration in the EU is met by stakeholders in the member states with reservation and often outright refusal, arguing that health systems are national competence subject to the subsidiary principle. This conundrum of asking for more but allowing for less has blocked a scientifically informed public debate about the EU and health policy. The overall objective of this workshop is to discuss how health research can contribute to resolve this conundrum making the EU more conducive to the needs of health systems, public health (PH) and Health in All Policies (HiAP). To this end we will review the following 4 specific topics What are is EU-health policy and what other policies are affecting health and health systems?What tells us the projected Brexit-impact on the UK health system and PH about the value of EU health policy?Are EU-trade policies shaping healthier commercial determinants of health?What is the added value of cross-border care at and beyond border regions? This workshop is based on the update of the seminal volume “Everything you always wanted to know about European Union health policies but were afraid to ask” (2019, 2nd edition). Key note Scott Greer: In health and health systems the European Union is ubiquitous. Health systems in Europe are hard to figure without the cross border mobility of health professions. Patients going cross-borders. We have a European Medicines Agency that is regulating key aspects of the pharmaceutical market. Health systems have become part of the economic governance of the EU. In PH we have the ECDC, a PH programme and policies on health related consumer protection and may mechanism that should protect European citizens from scourges that know no borders. With health in all policies, the EU legislates literally on all known agents and, when in doubt, is using the pre-cautionary principle to protect citizens from health hazards. All this is supported by a large EU research programme. Panellist 1 N Fahy, the projected impact of Brexit on health system functions of the United Kingdom demonstrates how deep the integration goes and how beneficial it is for both health systems and public health. Panellist 2 H Jarman: The discussion around the Transatlantic Trade an Investment Partnership (TTIP) have risen worries about privatization of health services and lowering of food standards. But TTIP is only the tip of the Iceberg given that the EU has several types of trade agreements with many countries and groups of countries, shaping the commercial determinants of health. Panellist 3 W Palm: Cross-border collaboration is already taking place in many border regions. The European reference networks demonstrate the value of the cross-border collaboration beyond border regions, as does collaboration for joint purchasing and health workforce development. Key messages Health is important at the EU level and the EU level is important for health. Not shaping health and health systems at EU level will limit the perspectives of EU integration, health system development public health and HiAP. Panelists Scott Greer Holly Jarman Contact: hjarman@umich.edu Nick Fahy Contact: nicholas.fahy@phc.ox.ac.uk Willy Palm Contact: wismarm@obs.who.int Contact: palmw@obs.who.int

Sri Lanka and the possibilities of achieving universal health coverage in a poor country

ABSTRACTSri Lanka has been lauded for providing good health coverage at a low cost despite having a modest per capita income. This article identifies the unique historical factors that enabled Sri Lanka to achieve near universal coverage, but it also discusses how this achievement is now being undermined by inadequate government investment in health services, the burdens of non-communicable diseases, and the growing privatisation of health services. In doing so, the article highlights the challenges of achieving and maintaining universal health coverage in a relatively low income country with a health system designed to treat infectious diseases and provide child and maternal health services as the country undergoes an epidemiological transition from infectious to non-communicable diseases. Using updated information on developments in the Sri Lankan health system, this article argues, in contrast with earlier publications, that Sri Lanka is no longer providing good health at a low cost. It shows that Sri Lanka’s low investment in health is detrimental and not an asset to achieving good health. The article also questions the possibilities of providing coverage for noncommunicable diseases at a low cost. The article has four main sections. The first details Sri Lanka’s accomplishments in moving toward universal health coverage. The second identifies the factors enabling Sri Lanka to do so. The third describes the equity and access challenges the health system now confronts. The fourth assesses what the Sri Lankan experience suggests about the requirements for universal health coverage when providing health services for treating non-communicable diseases becomes an important consideration.

From marketization to recentralization: the health-care system reforms in Poland and the post-New Public Management concept

The aim of the article is to evaluate the outcomes of the post-1990 health-care system reforms in Poland in the context of New Public Management and post-New Public Management ideas. The most important arguments put forward in the public debate, both in favour and against the agencification, marketization and privatization of health services, are presented and discussed. They are confronted with quantitative data on the health situation in Poland. In the final sections, the programme of the recentralization and de-marketization of the hospital sector, proposed by the new government formed by the Law and Justice Party (in office since 2015), is analysed against the theoretical background of the post-New Public Management concept. Points for practitioners The transformation of the health-care system in Poland took place in 1999, almost 10 years after the democratic breakthrough of 1989, as a part of the second wave of territorial-administrative reforms. Commercialization and partial privatization of public hospitals following the New Public Management model of public sector reform has been much discussed in Poland for the last decade. Yet, this process, which is politically and socially very controversial, has proceeded at a moderate pace. The recent government’s proposals for the de-agencification and de-marketization of health care may be interpreted as a post-New Public Management reform aimed at achieving higher standards of coordination within the system but also as another step towards the consolidation of political power for the ruling party.

Globalisation and health: a blessing or a curse? Case review of the Indian health system

Examination of the healthcare system in India and in particular the disparities in access to health services that exist between the rural poor and the urban rich and the impact that the increasing privatisation of health services is having on these populations. The article also considers the impact of medical tourism on the changing landscape of health services in the country and whether the benefits of this trickle-down to the poor.

Macroeconomic Determinants of Health Crises in Sub-Saharan Africa

The purpose of this article is to identify the macroeconomic determining factors of health crises. In order to reach our purpose, we use a logit model on a panel of 25 countries in sub-Saharan Africa from 1995 to 2012. The main results of this study indicate that international migration flows, the ratio of short-term debt by currency reserves, and the organization of the health care system explain health crises. These results imply that the poor management of information related to unforeseen events, the ability of reimbursement of the short-term debt, and the privatization of health services make most sub-Saharan African countries vulnerable to unforeseen events. This study suggests a better management of information related to unforeseen events, the increase of exportations and the improvement of the access to health services to all people during any unforeseen events outbreak.

Políticas del sector salud mexicano (1980-2004): ajuste estructural y pragmatismo de las propuestas neoliberales

In this paper we describe and analyze health policies impelled in Mexico during 1980-2004 (decentralization, health expenses reduction, selective primary health care, health services privatization) by neoliberal sectors. We describe the trajectory of these policies in a context characterized by poverty increase and socioeconomic inequalities. This analysis shows that these policies are characterized by their strong continuity, their adaptability, and in paticular their social, ideological and political pragmatism. The latter is evident in the use and appropriation by neoliberal functionaries and executives of concepts and proposals developed by medical and social critical approaches.

PRIVATISASI SISTEM PELAYANAN KESEHATAN DAN IMPUKASINYA BAGI PERUMUSAN AGENDA PENELITIAN DAN KEBIJAKAN PUBLIK

In the face of the increasing potential of negative first generation impactsof medical industrialization and the privatization of health services in anera of globalization (i.e., increased incidence of infectious deseases andmalnutrition among the poorest poor of Indonesian population), the authorof this article proposes the imperative of finding a middle-way policy solutionto integrate the public and private systems of health services to guaranteethe provision of high quality services and the availability of accessible healthservices for the poor. After presenting a short discussion of the weaknesses ofthe public health system, he discusses the issue of medical industrializationand the privatization of health service institutions, and ends up with thepresentation of five possible alternative of health service systems at thePUSKESMAS level.

The NHS at the Heart of the Election Campaign.

The 2015 general election in the UK saw the emergence of the health service and its future as one of the key points on the election battleground. This is because the NHS was flagged as one of the key issues of public concern. This is not just because of a commitment to the NHS but also the recognition of the pressures and strains on the public health service, widely publicised in both the popular and the quality press. The main issues of debate in the run up to the election were funding, stealth privatisation of health services, quality of health services and governance issues.

An Analysis of Users’ Perceptions on Health Facilities in Mumbai

The new challenges of globalisation have made it essential to achieve and sustain a high level of efficiency in the provision of healthcare. Even though the Government of Maharashtra clearly views assuring efficiency and providing public health services to the people as an important policy objective, data reveals that the amount of resources spent on public healthcare especially public hospitals is very meagre as compared to the needs of the population. This study attempts to understand the shift from public to the private health sector by the users of health services in the city of Mumbai. This changing trend towards increasing use of private hospitals for healthcare services was analysed to understand the specific reasons behind the privatisation of health services in this metropolitan city. Using primary survey, the analysis revealed that majority of the users preferred private hospital services due to various reasons like cleanliness, better infrastructure, efficient and competent doctors and other staff. The results also indicated significant inefficiencies in the functioning of the public hospitals as noted from the responses of the users.

Las reformas a la protección social en salud en México: ¿rupturas o continuidades?

Desde la década de los ochenta comenzó un proceso de reformas al sistema de salud mexicano con el fin de promover cambios estructurales en el sector mediante una mayor presencia del sector privado. Se argumenta que la reforma fue propuesta por un grupo de actores tecno-burocráticos que han concentrado recursos de poder cruciales para modificar las reglas institucionales y que tales cambios se han llevado a cabo sin consultar ampliamente a los diversos actores interesados: gobiernos de los estados de la república, proveedores de los servicios públicos y usuarios.Abstract This paper examines the reform process within the Mexican health system undertaken since the eighties that led to an increasing privatization of health services. It argues that such process have been led by a small group of techno-bureaucratic actors that have changed institutional rules according to their interests without considering the interests of local governments, public services providers and public health services users.

Signalling, status and inequities in maternal healthcare use in Punjab, Pakistan

Despite rising uptake of maternal healthcare in Pakistan, inequities persist. To-date, attempts to explain and address these differentials have focused predominantly on increasing awareness, geographic and financial accessibility. However, in a context where 70% of healthcare is private sector provided, it becomes pertinent to consider the value associated with this good. This study examined patterns of maternal healthcare use across socioeconomic groups within a rural community, and the meanings and values attached to this behaviour, to provide new insight into the causes of persistent inequity. A 10-month qualitative study was conducted in rural Punjab, Pakistan in 2010/11. Data were generated using 94 in-depth interviews, 11 focus group discussions and 134 observational sessions. Twenty-one pregnant women were followed longitudinally as case studies. The village was comprised of distinct social groups organised within a caste-based hierarchy. Complex patterns of maternal healthcare use were found, linked not only to material resources but also to the apparent social status associated with particular consumption patterns. The highest social group primarily used free public sector services; their social position ensuring receipt of acceptable care. The richer members of the middle social group used a local private midwife and actively constructed this behaviour as a symbol of wealth and status. Poorer members of this group felt pressure to use the afore-mentioned midwife despite the associated financial burden. The lowest social group lacked financial resources to use private sector services and opted instead to avoid use altogether and, in cases of complications, use public services. Han, Nunes, and Dreze's (2010) model of status consumption offers insight into these unexpected usage patterns. Privatization of healthcare within highly hierarchical societies may be susceptible to status consumption, resulting in unforeseen patterns of use and persistent inequities. To-date these influences have not been widely recognised, but they deserve greater scrutiny by researchers and policy-makers given the persistence of the private sector.

ÖZELLEŞTİRME: SAĞLIKTA ÖZELLEŞTİRME VE HEMŞİRELER

Privatization: Privatizaiton in Health And Nurses Privatizations those are defined as transfer of public goods and services to private sector, are implemented rapidly all over the world wih covering the health field. Privatization of health services to come up with many different applications and both health workers and public are affected from these applications in different dimensions. Nurses who are at the forefont in servicing health care and who are huge numbers of health workers are one of the most affected partials in health field. With the spread of privatization practices, those are set out nurses are working more hours, they are face to increased workload, precarious work, increased work non related nursing and increased nursing personnel don’t have lisence education.

Nurses' perceptions about health sector privatization in Turkey

The aim of this study is to identify the perceptions of the nurses about the privatization implementation, as it pertains to privatization, health services privatization and the impact of privatization on nursing in Turkey. Turkey is taking important steps in health services privatization but the related choices made in political arena are not shared with the employees of the health institutions where the privatization implementations are to take place. The study was conducted among nurses who are working for the state health institutions and the members of professional organizations of healthcare workers, which are operating in Istanbul in Turkey. Data were collected via Nurses' Privatization Perception Scale in 2009 and were analysed using mean calculations, analysis of variance, Mann-Whitney U-test, t-test, Kruskal-Wallis test and Cronbach's alpha analyses. Nurses' perceptions of privatization in general, health services privatization and the impact of privatization on nursing were found to be negative in all of the three sub-domains of the scale, as well as their perceptions of privatization implementations measured throughout the scale. The conducted comparisons showed that nurses' perceptions of the privatization implementations varied in accordance with independent variables. The privatization implementations put in place in health services are perceived negatively by nurses. Policy makers in relevant fields are recommended to take the findings of this study into consideration.

The Quest for Legitimacy in a Transitional Economy: A Comparison of Private Hospitals in China and Vietnam

The privatization of health services is an emerging trend in Asia. China and Vietnam are no exceptions, with their reforms to promote private hospitals gradually developed in early 1990s. As newcomers to the health-care system, private hospitals must achieve legitimacy in a state-dominated system in order to survive and develop. This paper describes the strategies of the quest to gain legitimacy from the state through “public-lization” and from the public through a campaign to associate private hospitals with professionalism, a caring environment, and customer orientation. It argues that, in a transitional economy, when the state is allocating power to other sectors but maintaining a central position, private hospitals must be careful to seek legitimacy from the state and, equally importantly, their customers. Improvements to the institutional environment to ensure better regulation are recommended, as well as professional self-scrutiny and consumer participation.

BMA plans to slow privatisation of health services

BMA plans to slow privatisation of health services