Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-745bb68f8f-f46jp Total loading time: 0 Render date: 2025-01-22T05:51:46.167Z Has data issue: false hasContentIssue false

12 - Paradigm shifts in the health sector: mission and methods

Published online by Cambridge University Press:  06 December 2010

Jean-Pierre Unger ,
Pierre De Paepe ,
Kasturi Sen  and
Werner Soors
By
Jean-Pierre Unger  and
P. Van Dessel
Jean-Pierre Unger
Affiliation:
Institute of Tropical Medicine Antwerp
Pierre De Paepe
Affiliation:
Institute of Tropical Medicine Antwerp
Kasturi Sen
Affiliation:
Institute of Tropical Medicine Antwerp
Werner Soors
Affiliation:
Institute of Tropical Medicine Antwerp
Get access

Summary

Adapted from: J.-P. Unger. How could disease-specific programmes strengthen health systems delivering comprehensive health care? Strategic and technical guidelines. European Commission, 30 September 2008, Brussels.

Part 1: The need to alter health systems' missions to deliver comprehensive care

The strengthening of health systems appears to have become a motto for international health agencies since 2003, when the former director of the WHO, Jong-Wook Lee (2003–2006), called for a radical re-think of policy, if diseases are to be successfully controlled (Jong-Wook,2003). This view has been echoed by his successor Margaret Chan. However, unlike the growing body of scientific papers that have begun to advocate the strengthening of health systems over the past several years, we would argue that health systems can only be strengthened if they are designed to deliver universally accessible comprehensive care. The remainder of this chapter outlines the rationale for this thinking.

Comprehensive health care: medical and managerial arguments

In a recent address to the 61st World Health Assembly, WHO Director, Dr Margaret Chan, acknowledged that the MDGs had stalled (see Section 1) (Chan, 2008). Besides the MDGs, the control of neglected diseases has also met with difficulties (see Section 1, Chapter 2).

Type
Chapter
Information
International Health and Aid Policies
The Need for Alternatives
 , pp. 155 - 163
Publisher: Cambridge University Press
Print publication year: 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baily, G. V., Savic, D., Gothi, G. D., Naidu, V. B., & Nair, S. S. (1967). Potential yield of pulmonary tuberculosis cases by direct microscopy of sputum in a district of South India. Bulletin of the World Health Organization, 37(6), pp. 875–92.Google Scholar
Banerji, D. & Andersen, R. (1963). A Sociological study of awareness of symptoms among persons with pulmonary tuberculosis. Bulletin of the World Health Organization, 29, pp. 665–83.Google ScholarPubMed
Brinkerhoff, D. & Leighton, C. (2002). Decentralization and Health System Reform. Insights for Implementers. Bethesda, MD: Partners for Health Reformplus (PHRplus).Google Scholar
Chan, M. (2008). Address to the 61st World Health Assembly. http://www.who.int/dg/speeches/2008/20080519/en/index.html.
,Department of Economic and Social Affairs. (2000). Charting the Progress of Populations. NewYork: United Nations Population Division. ST/ESA/SER.R/151.Google Scholar
El Sadr, W. M. & Hoos, D. (2008). The president's emergency plan for AIDS relief – Is the emergency over?New England Journal of Medicine, 359(6), pp. 553–5.CrossRefGoogle ScholarPubMed
,European Federation of Pharmaceutical Industries and Associations. (2007). Building Healthier Societies for Better Global Public Health. http://www.efpia.eu/Content/Default.asp?PageID=395.
Hadorn, D. C. (1991). Setting health care priorities in Oregon – Cost-effectiveness meets the rule of rescue. Journal of the American Medical Association, 265(17), pp. 2218–25.CrossRefGoogle ScholarPubMed
Hanson, S. & Hanson, C. (2008). HIV control in low-income countries in sub-Saharan Africa: Are the right things done?Global Health Action, 1, doi: 10.3402/gha.v1i0.1837.CrossRefGoogle Scholar
,Institute of Tropical Medicine Antwerp. (2007). MPH Programme – Health Sector Management and Policy, 2005–2007 data. Antwerp: Institute of Tropical Medicine.Google Scholar
Jong-Wook, L. (2003). Global health improvement and WHO: Shaping the future. Lancet, 362(9401), pp. 2083–8.CrossRefGoogle ScholarPubMed
McIntyre, D., Thiede, M., Dahlgren, G., & Whitehead, M. (2006). What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts?Social Science & Medicine, 62(4), pp. 858–65.CrossRefGoogle ScholarPubMed
Preker, A. S., Langenbrunner, J., & Suzuki, E. (2002). THE GLOBAL EXPENDITURE GAP, Securing Financial Protection and Access to Health Care for the Poor. Washington, DC: Commission on Macro Economics and Health, The World Bank.Google Scholar
Segall, M. (2003). District health systems in a neoliberal world: A review of five key policy areas. International Journal of Health Planning and Management, 18 p. S5–S26.CrossRefGoogle Scholar
Shiffman, J. (2008). Has donor prioritization of HIV/AIDS displaced aid for other health issues. Health Policy and Planning, 23(2), pp. 95–100.CrossRefGoogle ScholarPubMed
,The Pharmaceutical Research and Manufacturers of America. (2006). Health Care in the Developing World. http://world.phrma.org/.
,UNAIDS (2007). Financial Resources Required to Achieve Universal Access to HIV Prevention, Treatment, Care and Support. Geneva: UNAIDS.Google Scholar
,UNAIDS.(2008). 2008 Report on the Global AIDS Epidemic. Geneva: UNAIDS. UNAIDS/08.25E / JC1510E.Google Scholar
Unger, J. P. & Killingsworth, J. R. (1986). Selective primary health care: A critical review of methods and results. Social Science & Medicine, 22(10), pp. 1001–13.CrossRefGoogle ScholarPubMed
Doorslaer, E., O'Donnell, O., Rannan-Eliya, R. P., Somanathan, A., Adhikari, S. R., Garg, C. C., Harbianto, D., Herrin, A. N., Huq, M. N., Ibragimova, S., Karan, A., Ng, C. W., Pande, B. R., Racelis, R., Tao, S., Tin, K., Tisayaticom, K., Trisnantoro, L., Vasavid, C., & Zhao, Y. X. (2006). Effect of payments for health care on poverty estimates in 11 countries in Asia: An analysis of household survey data. Lancet, 368(9544), pp. 1357–64.CrossRefGoogle ScholarPubMed
Vander Plaetse, B., Hlatiwayo, G., Eygen, L., Meessen, B., & Criel, B. (2005). Costs and revenue of health care in a rural Zimbabwean district. Health Policy and Planning, 20(4), pp. 243–51.CrossRefGoogle Scholar
,World Health Organization. (1978). Declaration of Alma-Ata. In: Report of the International Conference on Primary Health Care, Alma Ata, USSR, 6–12 September 1978. Geneva: World Health Organization, pp. 2–6.Google Scholar
,World Health Organization. (1981). Global Strategy for Health for All by the Year 2000. Geneva: World Health Organization. WHA34.36.Google Scholar
,World Health Organization. (2000). Medicines Strategy: Framework for Action in Essential Drugs and Medicines Policy 2002–2003. Geneva: World Health Organization.Google Scholar
,World Health Organization. (2008). The Global Burden of Disease: 2004 update. Geneva: WHO Press, pp. 1–160.Google Scholar
Xu, K., Evans, D. B., Kawabata, K., Zeramdini, R., Klavus, J., & Murray, C. J. L. (2003). Household catastrophic health expenditure: A multicountry analysis. Lancet, 362(9378), pp. 111–7.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×