José M. Zuniga and Imane Sidibé
- Published in print:
- 2013
- Published Online:
- September 2013
- ISBN:
- 9780199661619
- eISBN:
- 9780191765056
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199661619.003.0024
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter reviews the human resources for health crises plaguing numerous countries around the globe and their effects on advancing the right to health. It focuses on: framing health worker ...
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This chapter reviews the human resources for health crises plaguing numerous countries around the globe and their effects on advancing the right to health. It focuses on: framing health worker engagement on the right to health as defined by human rights instruments and the work of various right to health advocates; addressing the human resources for health crises plaguing numerous countries and their impact on advancing the right to health; protecting health workers in their work environments, including conflict zones, and empowering them to fulfil their life-saving and life-enhancing work; and holding health workers accountable for human rights abuses and violations.Less
This chapter reviews the human resources for health crises plaguing numerous countries around the globe and their effects on advancing the right to health. It focuses on: framing health worker engagement on the right to health as defined by human rights instruments and the work of various right to health advocates; addressing the human resources for health crises plaguing numerous countries and their impact on advancing the right to health; protecting health workers in their work environments, including conflict zones, and empowering them to fulfil their life-saving and life-enhancing work; and holding health workers accountable for human rights abuses and violations.
Barbara McPake
- Published in print:
- 2011
- Published Online:
- January 2012
- ISBN:
- 9780199566761
- eISBN:
- 9780191731181
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199566761.003.0052
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
The health workforce is the component of the health sector that determines the efficiency with which all others function. Conceived broadly to include all those who are ‘primarily engaged in actions ...
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The health workforce is the component of the health sector that determines the efficiency with which all others function. Conceived broadly to include all those who are ‘primarily engaged in actions with the primary intent of enhancing health’, the health workforce includes those who directly deliver health services, and those who determine what should be delivered, what can be delivered given available resources, and what will be delivered in reality; those who identify health information requirements, make plans, implement plans, and collect data; those who identify what medical products, vaccines, and technologies are purchased, stored, and distributed, and the standards applied at all stages; those who identify financing strategies and put them into practice at all levels; and those who establish leadership and governance systems, lead, and govern. This chapter outlines the current state of play concerning human resources in health, and the role of migration and the response of high- and middle/low-income countries. It then focuses on two case studies of Kenya and Ghana, before concluding with policy implications.Less
The health workforce is the component of the health sector that determines the efficiency with which all others function. Conceived broadly to include all those who are ‘primarily engaged in actions with the primary intent of enhancing health’, the health workforce includes those who directly deliver health services, and those who determine what should be delivered, what can be delivered given available resources, and what will be delivered in reality; those who identify health information requirements, make plans, implement plans, and collect data; those who identify what medical products, vaccines, and technologies are purchased, stored, and distributed, and the standards applied at all stages; those who identify financing strategies and put them into practice at all levels; and those who establish leadership and governance systems, lead, and govern. This chapter outlines the current state of play concerning human resources in health, and the role of migration and the response of high- and middle/low-income countries. It then focuses on two case studies of Kenya and Ghana, before concluding with policy implications.
Mario Roberto Dal Poz, Norbert Dreesch, and Dingie van Rensburg
- Published in print:
- 2008
- Published Online:
- September 2009
- ISBN:
- 9780199225859
- eISBN:
- 9780191723834
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199225859.003.0028
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter analyzes the growing demands of HIV/AIDS care on existing human resources for health (HRH). The pressures on these resources have multiplied and steered many national health systems into ...
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This chapter analyzes the growing demands of HIV/AIDS care on existing human resources for health (HRH). The pressures on these resources have multiplied and steered many national health systems into ever deeper troubled waters as a result of dire and aggravating human resource shortages and deficits. This is especially the case in those countries hardest hit by the epidemic, and with the recent scale-up of antiretroviral therapy (ART). The crux of the crisis is related to growing mismatches between demand and supply of human resources.Less
This chapter analyzes the growing demands of HIV/AIDS care on existing human resources for health (HRH). The pressures on these resources have multiplied and steered many national health systems into ever deeper troubled waters as a result of dire and aggravating human resource shortages and deficits. This is especially the case in those countries hardest hit by the epidemic, and with the recent scale-up of antiretroviral therapy (ART). The crux of the crisis is related to growing mismatches between demand and supply of human resources.
Gillian Abel and Lisa Fitzgerald
- Published in print:
- 2010
- Published Online:
- March 2012
- ISBN:
- 9781847423344
- eISBN:
- 9781447303664
- Item type:
- chapter
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781847423344.003.0013
- Subject:
- Social Work, Crime and Justice
In the sex-worker population, the priority of harm minimisation has been to minimise disease transmission through educating the workers on safe-sex practices. This harm-minimisation approach assumes ...
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In the sex-worker population, the priority of harm minimisation has been to minimise disease transmission through educating the workers on safe-sex practices. This harm-minimisation approach assumes that by educating the sex workers on HIV/AIDS and informing them of their responsibility in preventing transmission, they would make rational choices to protect themselves and others. However, the assumption that sex workers are vectors of diseases marginalises and blames them without considering the implications of poverty, gender, public fear, and law. For a more effective health approach in the sex industry, it is hence vital to consider structural and political issues such as poverty and law. Within this context, public-health workers have been challenged to take a more holistic approach to health promotion for sex workers. In addition to taking into consideration the health of the workers, their human rights and the need to create a safer working environment were also considered in the risk-management and harm-minimisation assessment of the sex industry. Within the broad context of harm minimisation commenced the advocacy for the decriminalisation of the sex industry. It was envisaged that by repealing the laws which criminalised sex-work activities, the autonomy of the sex workers and their capability to protect themselves would increase. It was theorised that under a decriminalised system, human rights and set standards for working environments would improve the health and safety of the workers. This chapter examines whether there have been gains for sex-worker health and safety in a decriminalised environment. It examines the main threats to health and safety identified by the participants: risks to sexual health, risks of violence and exploitation, and risks to emotional health.Less
In the sex-worker population, the priority of harm minimisation has been to minimise disease transmission through educating the workers on safe-sex practices. This harm-minimisation approach assumes that by educating the sex workers on HIV/AIDS and informing them of their responsibility in preventing transmission, they would make rational choices to protect themselves and others. However, the assumption that sex workers are vectors of diseases marginalises and blames them without considering the implications of poverty, gender, public fear, and law. For a more effective health approach in the sex industry, it is hence vital to consider structural and political issues such as poverty and law. Within this context, public-health workers have been challenged to take a more holistic approach to health promotion for sex workers. In addition to taking into consideration the health of the workers, their human rights and the need to create a safer working environment were also considered in the risk-management and harm-minimisation assessment of the sex industry. Within the broad context of harm minimisation commenced the advocacy for the decriminalisation of the sex industry. It was envisaged that by repealing the laws which criminalised sex-work activities, the autonomy of the sex workers and their capability to protect themselves would increase. It was theorised that under a decriminalised system, human rights and set standards for working environments would improve the health and safety of the workers. This chapter examines whether there have been gains for sex-worker health and safety in a decriminalised environment. It examines the main threats to health and safety identified by the participants: risks to sexual health, risks of violence and exploitation, and risks to emotional health.
Nizam Damani
- Published in print:
- 2011
- Published Online:
- May 2012
- ISBN:
- 9780199698356
- eISBN:
- 9780191732126
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199698356.003.0016
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
The protection of health care workers should be an integral part of the health and safety programme of all health care facilities. Health care facilities have a legal obligation to ensure that all ...
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The protection of health care workers should be an integral part of the health and safety programme of all health care facilities. Health care facilities have a legal obligation to ensure that all their employees are appropriately trained and proficient in the procedures necessary for working safely. In addition, it is the responsibility of every employee to be aware of their own role in infection prevention and control, and incorporate good practices into their daily activity to ensure that they do not jeopardize the health and safety of themselves or any other person. This chapter discusses the role of occupational health departments, pre-employment assessment, health status of health care workers, measures to protect health care workers, management of sharps injuries, protection against tuberculosis, and pregnant health care workers.Less
The protection of health care workers should be an integral part of the health and safety programme of all health care facilities. Health care facilities have a legal obligation to ensure that all their employees are appropriately trained and proficient in the procedures necessary for working safely. In addition, it is the responsibility of every employee to be aware of their own role in infection prevention and control, and incorporate good practices into their daily activity to ensure that they do not jeopardize the health and safety of themselves or any other person. This chapter discusses the role of occupational health departments, pre-employment assessment, health status of health care workers, measures to protect health care workers, management of sharps injuries, protection against tuberculosis, and pregnant health care workers.
Virginia Berridge
- Published in print:
- 1996
- Published Online:
- October 2011
- ISBN:
- 9780198204725
- eISBN:
- 9780191676376
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198204725.003.0004
- Subject:
- History, British and Irish Modern History
AIDS had been an issue for gay men, for clinicians and scientists, since 1982. AIDS assumed the dimensions of a serious public, departmental, and political issue during the course of 1985. From late ...
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AIDS had been an issue for gay men, for clinicians and scientists, since 1982. AIDS assumed the dimensions of a serious public, departmental, and political issue during the course of 1985. From late 1984 and into 1985, AIDS began to impinge on the public consciousness to a much greater extent than it had done before. The number of AIDS deaths hit the press headlines. Professional groups, nurses, and laboratory workers showed concern, and politicians began to press for a response based on exclusion and isolation. Both the media and public opinion in general supported such a line, and significant pressure groups close to the government wanted a response based on the assertion of family values. The economics of AIDS also had a part to play, as did the question of health-care worker infection.Less
AIDS had been an issue for gay men, for clinicians and scientists, since 1982. AIDS assumed the dimensions of a serious public, departmental, and political issue during the course of 1985. From late 1984 and into 1985, AIDS began to impinge on the public consciousness to a much greater extent than it had done before. The number of AIDS deaths hit the press headlines. Professional groups, nurses, and laboratory workers showed concern, and politicians began to press for a response based on exclusion and isolation. Both the media and public opinion in general supported such a line, and significant pressure groups close to the government wanted a response based on the assertion of family values. The economics of AIDS also had a part to play, as did the question of health-care worker infection.
Jane South, Judy White, and Mark Gamsu
- Published in print:
- 2012
- Published Online:
- May 2013
- ISBN:
- 9781447305316
- eISBN:
- 9781447307808
- Item type:
- chapter
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781447305316.003.0003
- Subject:
- Public Health and Epidemiology, Public Health
This chapter gives an overview of the history of lay health workers and the diversity of current practice. It examines how the concept of community health workers originated in the 1970s as part of a ...
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This chapter gives an overview of the history of lay health workers and the diversity of current practice. It examines how the concept of community health workers originated in the 1970s as part of a holistic approach to primary health care. International case studies are used to illustrate the traditions that have since emerged in both the global South and North America. Lessons learnt from programme implementation highlight the importance of community ownership and supportive health systems. In the UK an increasing emphasis on self care and health prevention has led to several major initiatives, including the Expert Patient Programme, health trainers and community health champions. The chapter also considers independent social action on health and how this relates to more professionally directed programmes.Less
This chapter gives an overview of the history of lay health workers and the diversity of current practice. It examines how the concept of community health workers originated in the 1970s as part of a holistic approach to primary health care. International case studies are used to illustrate the traditions that have since emerged in both the global South and North America. Lessons learnt from programme implementation highlight the importance of community ownership and supportive health systems. In the UK an increasing emphasis on self care and health prevention has led to several major initiatives, including the Expert Patient Programme, health trainers and community health champions. The chapter also considers independent social action on health and how this relates to more professionally directed programmes.
Suneeta Krishnan
- Published in print:
- 2009
- Published Online:
- September 2009
- ISBN:
- 9780195310276
- eISBN:
- 9780199865369
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195310276.003.07
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter looks at experiences providing health care to rural women in India. It shares thoughts about the quality of health care offered to women. The chapter also describes the establishment of ...
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This chapter looks at experiences providing health care to rural women in India. It shares thoughts about the quality of health care offered to women. The chapter also describes the establishment of the Well Woman Clinics, aimed at providing empathic reproductive health care, including information, counseling, and clinical services to women. Community health workers (CHWs) were trained to take a comprehensive, broadly defined health history and provide pre-examination counseling to help women assess what kind of clinical consultation they required and become acquainted with routine examinations.Less
This chapter looks at experiences providing health care to rural women in India. It shares thoughts about the quality of health care offered to women. The chapter also describes the establishment of the Well Woman Clinics, aimed at providing empathic reproductive health care, including information, counseling, and clinical services to women. Community health workers (CHWs) were trained to take a comprehensive, broadly defined health history and provide pre-examination counseling to help women assess what kind of clinical consultation they required and become acquainted with routine examinations.
Mike Saks
- Published in print:
- 2008
- Published Online:
- March 2012
- ISBN:
- 9781861349569
- eISBN:
- 9781447303251
- Item type:
- chapter
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781861349569.003.0011
- Subject:
- Public Health and Epidemiology, Public Health
This chapter compares the marginal, but intersecting, groups of health support workers and practitioners of complementary and alternative medicine in the UK, with particular reference to changing ...
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This chapter compares the marginal, but intersecting, groups of health support workers and practitioners of complementary and alternative medicine in the UK, with particular reference to changing national policy and workforce dynamics. It considers the background to each of these areas, as well as recent policies impacting upon them in more detail alongside the mainstream political, social and economic drivers of reform. This enables a number of comparisons to be drawn. In both cases the associated workforce dynamics have impacted on the healthcare division of labour, with differential moves towards professionalisation, which bring potential regulatory benefits as well as costs for the health workers concerned and the wider public.Less
This chapter compares the marginal, but intersecting, groups of health support workers and practitioners of complementary and alternative medicine in the UK, with particular reference to changing national policy and workforce dynamics. It considers the background to each of these areas, as well as recent policies impacting upon them in more detail alongside the mainstream political, social and economic drivers of reform. This enables a number of comparisons to be drawn. In both cases the associated workforce dynamics have impacted on the healthcare division of labour, with differential moves towards professionalisation, which bring potential regulatory benefits as well as costs for the health workers concerned and the wider public.
Arima Mishra, Rune Flikke, Cecilie Nordfeldt, and Lot Nyirenda
- Published in print:
- 2013
- Published Online:
- September 2013
- ISBN:
- 9780199666447
- eISBN:
- 9780191749285
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199666447.003.0006
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
However it is measured, the success of an immunisation programme depends ultimately on what happens at the interface between the national health system and a local community. In many countries this ...
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However it is measured, the success of an immunisation programme depends ultimately on what happens at the interface between the national health system and a local community. In many countries this interface is manifested as routine immunisation days and outreach clinics. Drawing on detailed ethnographic research in India and Malawi, this chapter discusses the activities taking place at these sites. Success depends on numerousfactors, including the trust the health workers enjoy in the community as well as the trust people have in the health services, on the other services they provide, on an adequate and reliable supply of vaccines, and on health workers’ own motivations and incentives. The chapter examines how local health workers in different settings to reconcile,the demands of ensuring that targets are met and developing a relationship of trust with the community. It also discusses how responses to immunisation are sustained, negotiated, and/or reinterpreted in local communities.Less
However it is measured, the success of an immunisation programme depends ultimately on what happens at the interface between the national health system and a local community. In many countries this interface is manifested as routine immunisation days and outreach clinics. Drawing on detailed ethnographic research in India and Malawi, this chapter discusses the activities taking place at these sites. Success depends on numerousfactors, including the trust the health workers enjoy in the community as well as the trust people have in the health services, on the other services they provide, on an adequate and reliable supply of vaccines, and on health workers’ own motivations and incentives. The chapter examines how local health workers in different settings to reconcile,the demands of ensuring that targets are met and developing a relationship of trust with the community. It also discusses how responses to immunisation are sustained, negotiated, and/or reinterpreted in local communities.
Jane South, Judy White, and Mark Gamsu
- Published in print:
- 2012
- Published Online:
- May 2013
- ISBN:
- 9781447305316
- eISBN:
- 9781447307808
- Item type:
- book
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781447305316.001.0001
- Subject:
- Public Health and Epidemiology, Public Health
People-centred public health examines how members of the public can be involved in delivering health improvement, primarily as volunteers or lay health workers. With a foreword by Professor Sir ...
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People-centred public health examines how members of the public can be involved in delivering health improvement, primarily as volunteers or lay health workers. With a foreword by Professor Sir Michael Marmot and Dr Mike Grady, this book draws on a major study of lay engagement in public health, using case studies and real life examples to provide a comprehensive and accessible overview of policy, practice and research in this area. In an economic and political climate where there is renewed interest in the role of the citizen, the authors challenge old orthodoxies in public health and build a coherent argument for radical change in the way public agencies support lay action. The book provides contemporary insights into why, how and with what support people can move from being health consumers to active citizens who are able to make a valued contribution to health. The book is aimed at readers with an academic or professional interest in public health, health promotion, public sector management, social policy and community work.Less
People-centred public health examines how members of the public can be involved in delivering health improvement, primarily as volunteers or lay health workers. With a foreword by Professor Sir Michael Marmot and Dr Mike Grady, this book draws on a major study of lay engagement in public health, using case studies and real life examples to provide a comprehensive and accessible overview of policy, practice and research in this area. In an economic and political climate where there is renewed interest in the role of the citizen, the authors challenge old orthodoxies in public health and build a coherent argument for radical change in the way public agencies support lay action. The book provides contemporary insights into why, how and with what support people can move from being health consumers to active citizens who are able to make a valued contribution to health. The book is aimed at readers with an academic or professional interest in public health, health promotion, public sector management, social policy and community work.
Jane South, Judy White, and Mark Gamsu
- Published in print:
- 2012
- Published Online:
- May 2013
- ISBN:
- 9781447305316
- eISBN:
- 9781447307808
- Item type:
- chapter
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781447305316.003.0001
- Subject:
- Public Health and Epidemiology, Public Health
The aim of the book is to provide a comprehensive overview of major themes for policy and practice relating to lay engagement in public health activities. This chapter introduces the structure and ...
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The aim of the book is to provide a comprehensive overview of major themes for policy and practice relating to lay engagement in public health activities. This chapter introduces the structure and scope of the book. It argues that active citizenship is a key issue for public health in the 21st century, both in the UK and internationally, and can been seen as part of a wider movement for greater patient and public involvement in health governance. Community participation is defined with reference to different interpretations and conceptual debates. The notion of lay health workers is introduced and examples of active roles in health improvement are given. The chapter describes the origins of the book and the evidence gathered through the ‘People in Public Health’ study.Less
The aim of the book is to provide a comprehensive overview of major themes for policy and practice relating to lay engagement in public health activities. This chapter introduces the structure and scope of the book. It argues that active citizenship is a key issue for public health in the 21st century, both in the UK and internationally, and can been seen as part of a wider movement for greater patient and public involvement in health governance. Community participation is defined with reference to different interpretations and conceptual debates. The notion of lay health workers is introduced and examples of active roles in health improvement are given. The chapter describes the origins of the book and the evidence gathered through the ‘People in Public Health’ study.
Zafrullah Chowdhury and Sarah L. Bachman
- Published in print:
- 2009
- Published Online:
- September 2009
- ISBN:
- 9780195310276
- eISBN:
- 9780199865369
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195310276.003.02
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter presents an account of the establishment of primary health care in Gonoshasthaya Kendrai, Bangladesh. It describes experiences in a medical team that arrived in Bangladesh to provide ...
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This chapter presents an account of the establishment of primary health care in Gonoshasthaya Kendrai, Bangladesh. It describes experiences in a medical team that arrived in Bangladesh to provide medical care to wounded freedom fighters and refugees, and their eventual training of girls to become paramedics. The paramedics at GK provided various services from basic health care to family planning to surgical operations. Since most of them were from the community, they knew the local language, dialects, and pronunciations. They also understood how the community mind works. As a result, they were often more effective in the field than doctors.Less
This chapter presents an account of the establishment of primary health care in Gonoshasthaya Kendrai, Bangladesh. It describes experiences in a medical team that arrived in Bangladesh to provide medical care to wounded freedom fighters and refugees, and their eventual training of girls to become paramedics. The paramedics at GK provided various services from basic health care to family planning to surgical operations. Since most of them were from the community, they knew the local language, dialects, and pronunciations. They also understood how the community mind works. As a result, they were often more effective in the field than doctors.
Joia S. Mukherjee
- Published in print:
- 2017
- Published Online:
- December 2017
- ISBN:
- 9780190662455
- eISBN:
- 9780190662486
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780190662455.003.0008
- Subject:
- Public Health and Epidemiology, Public Health
Community Health Workers (CHW) are an important cadre of health care personnel, particularly in impoverished countries. CHW program began with China’s “Barefoot Doctor” campaign. The Barefoot Doctors ...
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Community Health Workers (CHW) are an important cadre of health care personnel, particularly in impoverished countries. CHW program began with China’s “Barefoot Doctor” campaign. The Barefoot Doctors were lay people educated to provide basic medical education and care in rural China in the 1950s–1970s. CHWs have evolved over the years and now perform a variety of functions in many countries, from education to prevention, case finding to treatment, and referral to follow-up. This cadre is often used to fill the gap in human resources. There are a number of challenges in scaling up and sustaining CHW programs, including the adequate training, compensation, and supervision of CHWs within the health system. This chapter will begin with a historical look at the roots of CHW programs, explore their current status, and address some of the challenges inherent in fully utilizing the potential of this group of health workers.Less
Community Health Workers (CHW) are an important cadre of health care personnel, particularly in impoverished countries. CHW program began with China’s “Barefoot Doctor” campaign. The Barefoot Doctors were lay people educated to provide basic medical education and care in rural China in the 1950s–1970s. CHWs have evolved over the years and now perform a variety of functions in many countries, from education to prevention, case finding to treatment, and referral to follow-up. This cadre is often used to fill the gap in human resources. There are a number of challenges in scaling up and sustaining CHW programs, including the adequate training, compensation, and supervision of CHWs within the health system. This chapter will begin with a historical look at the roots of CHW programs, explore their current status, and address some of the challenges inherent in fully utilizing the potential of this group of health workers.
Ronald Labonté and Arne Ruckert
- Published in print:
- 2019
- Published Online:
- May 2019
- ISBN:
- 9780198835356
- eISBN:
- 9780191872952
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780198835356.003.0009
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
Health systems rely upon two groups of people: health workers and patients. In recent decades both groups have been on the move globally, with the creation of internationalized labour market ...
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Health systems rely upon two groups of people: health workers and patients. In recent decades both groups have been on the move globally, with the creation of internationalized labour market opportunities (the hunt for skilled labour in the case of health workers) and private investments in high-end health care on lower-cost developing countries (one of the key incentives for patients seeking care outside of their own country, for uninsured or under-insured services). Both flows raise a number of health equity concerns. Health worker migration can pose undue hardships on low-resource, high-disease burden countries who lose their workers to richer nations, creating a ‘perverse subsidy’ of poor to rich. With medical tourism, private, fee-paying foreign patients in poorer countries could ‘crowd out’ access to care for domestic patients in those countries, while potentially returning with drug resistant infections or complications burdening their home country’s health systems.Less
Health systems rely upon two groups of people: health workers and patients. In recent decades both groups have been on the move globally, with the creation of internationalized labour market opportunities (the hunt for skilled labour in the case of health workers) and private investments in high-end health care on lower-cost developing countries (one of the key incentives for patients seeking care outside of their own country, for uninsured or under-insured services). Both flows raise a number of health equity concerns. Health worker migration can pose undue hardships on low-resource, high-disease burden countries who lose their workers to richer nations, creating a ‘perverse subsidy’ of poor to rich. With medical tourism, private, fee-paying foreign patients in poorer countries could ‘crowd out’ access to care for domestic patients in those countries, while potentially returning with drug resistant infections or complications burdening their home country’s health systems.
Gustavo de Simone
- Published in print:
- 2007
- Published Online:
- November 2011
- ISBN:
- 9780198569855
- eISBN:
- 9780191730443
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198569855.003.0011
- Subject:
- Palliative Care, Palliative Medicine Research, Patient Care and End-of-Life Decision Making
Palliative care requires attention to the wide range of symptoms affecting patients with progressive diseases, emotional and cultural issues that accompany advanced illness and the needs of family ...
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Palliative care requires attention to the wide range of symptoms affecting patients with progressive diseases, emotional and cultural issues that accompany advanced illness and the needs of family members, including bereavement. There are enormous needs and many opportunities for palliative care education in South America. Most ambitious medical graduates are attracted to curative procedures while nurses often lack the status to advocate for their patients with effect. It is not easy to identify outcomes for these education initiatives, as most of them lack proper audit measures. There is insufficient collaboration and coordination among different programmes. Despite these limitations, it is highly probable that most of the positive changes observed at clinical practice and policies have their origins in the educational effort of a few health workers who deserve strong encouragement and much practical support.Less
Palliative care requires attention to the wide range of symptoms affecting patients with progressive diseases, emotional and cultural issues that accompany advanced illness and the needs of family members, including bereavement. There are enormous needs and many opportunities for palliative care education in South America. Most ambitious medical graduates are attracted to curative procedures while nurses often lack the status to advocate for their patients with effect. It is not easy to identify outcomes for these education initiatives, as most of them lack proper audit measures. There is insufficient collaboration and coordination among different programmes. Despite these limitations, it is highly probable that most of the positive changes observed at clinical practice and policies have their origins in the educational effort of a few health workers who deserve strong encouragement and much practical support.
Joia S. Mukherjee
- Published in print:
- 2017
- Published Online:
- December 2017
- ISBN:
- 9780190662455
- eISBN:
- 9780190662486
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780190662455.003.0007
- Subject:
- Public Health and Epidemiology, Public Health
Impoverished countries face what has been termed a human resource crisis. Decades of under-resourced training programs, low public sector wages, and poor working conditions have led to shortages of ...
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Impoverished countries face what has been termed a human resource crisis. Decades of under-resourced training programs, low public sector wages, and poor working conditions have led to shortages of health workers and the underperformance of staff where the burden of disease is the highest. In this chapter, the causes of the human resource crisis are explained and the gaps in training and retention of personnel are described. The chapter outlines new programs, such as the Medical Education Partnership Initiative (MEPI), Nursing Education Partnership Initiative (NEPI), and the Rwanda government’s national Human Resources for Health program. All of these programs are working with governments to increase the numbers of health professionals trained and improve their clinical capacity through long-term training and mentorship.Less
Impoverished countries face what has been termed a human resource crisis. Decades of under-resourced training programs, low public sector wages, and poor working conditions have led to shortages of health workers and the underperformance of staff where the burden of disease is the highest. In this chapter, the causes of the human resource crisis are explained and the gaps in training and retention of personnel are described. The chapter outlines new programs, such as the Medical Education Partnership Initiative (MEPI), Nursing Education Partnership Initiative (NEPI), and the Rwanda government’s national Human Resources for Health program. All of these programs are working with governments to increase the numbers of health professionals trained and improve their clinical capacity through long-term training and mentorship.
Justin Amery (ed.)
- Published in print:
- 2009
- Published Online:
- November 2011
- ISBN:
- 9780199567966
- eISBN:
- 9780191730566
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199567966.001.0001
- Subject:
- Palliative Care, Paediatric Palliative Medicine, Patient Care and End-of-Life Decision Making
Children's palliative care has developed rapidly as a discipline, as health-care professionals recognise that the principles of adult palliative care may not always be applicable to children at the ...
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Children's palliative care has developed rapidly as a discipline, as health-care professionals recognise that the principles of adult palliative care may not always be applicable to children at the end of life. The unique needs of dying children are particularly evident across Africa, where the scale of the problem is overwhelming and the figures so enormous that they are barely comprehensible: over 400,000 children in Africa died from AIDS in 2003, and out of the 166,000 children a year diagnosed with cancer, 84% of these are in the developing world. Despite the enormous need, provision of children's palliative care in Africa is almost non-existent, with very few health workers trained and confident to provide care for dying children. The challenges of providing palliative care in this setting are different to those in more developed countries, contending with the shortage of physical and human resources in addition to the vast scope of the care needed. Written by a group with wide experience of caring for dying children in Africa, this book provides guidance on improving access to, and delivery of, palliative care in this demanding setting. It looks at the themes common to palliative care — including communication, assessment, symptom management, psychosocial issues, ethical dilemmas, end-of-life care, and tips for the professional on compassion and conservation of energy — but always retains the focus on the particular needs of the health-care professional in Africa. Whilst containing some theory, the emphasis is on practical action throughout.Less
Children's palliative care has developed rapidly as a discipline, as health-care professionals recognise that the principles of adult palliative care may not always be applicable to children at the end of life. The unique needs of dying children are particularly evident across Africa, where the scale of the problem is overwhelming and the figures so enormous that they are barely comprehensible: over 400,000 children in Africa died from AIDS in 2003, and out of the 166,000 children a year diagnosed with cancer, 84% of these are in the developing world. Despite the enormous need, provision of children's palliative care in Africa is almost non-existent, with very few health workers trained and confident to provide care for dying children. The challenges of providing palliative care in this setting are different to those in more developed countries, contending with the shortage of physical and human resources in addition to the vast scope of the care needed. Written by a group with wide experience of caring for dying children in Africa, this book provides guidance on improving access to, and delivery of, palliative care in this demanding setting. It looks at the themes common to palliative care — including communication, assessment, symptom management, psychosocial issues, ethical dilemmas, end-of-life care, and tips for the professional on compassion and conservation of energy — but always retains the focus on the particular needs of the health-care professional in Africa. Whilst containing some theory, the emphasis is on practical action throughout.
Makoto Ishida
- Published in print:
- 2004
- Published Online:
- March 2012
- ISBN:
- 9780199271818
- eISBN:
- 9780191699542
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199271818.003.0012
- Subject:
- Law, Employment Law
This chapter looks towards Japan and discusses death and suicide resulting from the stress of overwork, offering a stark picture of the ‘dark side’ of the once highly touted ‘Japanese miracle’. It ...
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This chapter looks towards Japan and discusses death and suicide resulting from the stress of overwork, offering a stark picture of the ‘dark side’ of the once highly touted ‘Japanese miracle’. It shows how laws designed to prevent overwork and compensate for industrial injuries were undermined in Japan by judicial decisions and cultural practices, but concludes that the pressures of the ‘new’ economy may soon bring similar problems to workplaces everywhere.Less
This chapter looks towards Japan and discusses death and suicide resulting from the stress of overwork, offering a stark picture of the ‘dark side’ of the once highly touted ‘Japanese miracle’. It shows how laws designed to prevent overwork and compensate for industrial injuries were undermined in Japan by judicial decisions and cultural practices, but concludes that the pressures of the ‘new’ economy may soon bring similar problems to workplaces everywhere.
Susanna F. Schaller, K. C. Wagner, and Mildred E. Warner
- Published in print:
- 2017
- Published Online:
- January 2018
- ISBN:
- 9781501706547
- eISBN:
- 9781501712692
- Item type:
- chapter
- Publisher:
- Cornell University Press
- DOI:
- 10.7591/cornell/9781501706547.003.0008
- Subject:
- Economics and Finance, Public and Welfare
This chapter addresses the duality of labor strategy in the child care sector with one case study of unions campaigning to expand their members' access to child care benefits, paired with a second ...
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This chapter addresses the duality of labor strategy in the child care sector with one case study of unions campaigning to expand their members' access to child care benefits, paired with a second case study of a union organizing a campaign that combined direct organizing of child care providers with public policy development. The first case study tells the story of how a highly feminized union representing health care workers won child care benefits in collective bargaining, subsequently campaigned as part of a multiunion fare benefit, and expanded access to child care for low- and middle-income wage earners. The second case follows a United Federation of Teachers (UFT)-driven labor-community campaign to organize home-based child care providers, which represent a low-wage segment of the child care workforce that has emerged in the context of privatization and voucherization.Less
This chapter addresses the duality of labor strategy in the child care sector with one case study of unions campaigning to expand their members' access to child care benefits, paired with a second case study of a union organizing a campaign that combined direct organizing of child care providers with public policy development. The first case study tells the story of how a highly feminized union representing health care workers won child care benefits in collective bargaining, subsequently campaigned as part of a multiunion fare benefit, and expanded access to child care for low- and middle-income wage earners. The second case follows a United Federation of Teachers (UFT)-driven labor-community campaign to organize home-based child care providers, which represent a low-wage segment of the child care workforce that has emerged in the context of privatization and voucherization.
