Health systems and reform最新文献

Efficient and Effective Diabetes Care in the Era of Digitalization and Hypercompetitive Research Culture: A Focused Review in the Western Pacific Region with Malaysia as a Case Study. 数字化和超竞争研究文化时代的高效和有效的糖尿病护理：西太平洋地区以马来西亚为例的重点回顾。

Health systems and reform Pub Date : 2025-12-31 Epub Date: 2025-01-06 DOI: 10.1080/23288604.2024.2417788

Boon-How Chew, Pauline Siew Mei Lai, Dhashani A/P Sivaratnam, Nurul Iftida Basri, Geeta Appannah, Barakatun Nisak Mohd Yusof, Subashini C Thambiah, Zubaidah Nor Hanipah, Ping-Foo Wong, Li-Cheng Chang

{"title":"Efficient and Effective Diabetes Care in the Era of Digitalization and Hypercompetitive Research Culture: A Focused Review in the Western Pacific Region with Malaysia as a Case Study.","authors":"Boon-How Chew, Pauline Siew Mei Lai, Dhashani A/P Sivaratnam, Nurul Iftida Basri, Geeta Appannah, Barakatun Nisak Mohd Yusof, Subashini C Thambiah, Zubaidah Nor Hanipah, Ping-Foo Wong, Li-Cheng Chang","doi":"10.1080/23288604.2024.2417788","DOIUrl":"https://doi.org/10.1080/23288604.2024.2417788","url":null,"abstract":"There are approximately 220 million (about 12% regional prevalence) adults living with diabetes mellitus (DM) with its related complications, and morbidity knowingly or unconsciously in the Western Pacific Region (WP). The estimated healthcare cost in the WP and Malaysia was 240 billion USD and 1.0 billion USD in 2021 and 2017, respectively, with unmeasurable suffering and loss of health quality and economic productivity. This urgently calls for nothing less than concerted and preventive efforts from all stakeholders to invest in transforming healthcare professionals and reforming the healthcare system that prioritizes primary medical care setting, empowering allied health professionals, improvising health organization for the healthcare providers, improving health facilities and non-medical support for the people with DM. This article alludes to challenges in optimal diabetes care and proposes evidence-based initiatives over a 5-year period in a detailed roadmap to bring about dynamic and efficient healthcare services that are effective in managing people with DM using Malaysia as a case study for reference of other countries with similar backgrounds and issues. This includes a scanning on the landscape of clinical research in DM, dimensions and spectrum of research misconducts, possible common biases along the whole research process, key preventive strategies, implementation and limitations toward high-quality research. Lastly, digital medicine and how artificial intelligence could contribute to diabetes care and open science practices in research are also discussed.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2417788"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Public Policy and Health System Responses to Diabetes Mellitus in Nigeria: A Call for Reform. 尼日利亚对糖尿病的公共政策和卫生系统反应：呼吁改革。

Health systems and reform Pub Date : 2025-12-31 Epub Date: 2025-03-12 DOI: 10.1080/23288604.2025.2477941

Friday Okonofua, Lorretta Favour Ntoimo, Rosemary Ogu, Maradona Isikhuemen

{"title":"Public Policy and Health System Responses to Diabetes Mellitus in Nigeria: A Call for Reform.","authors":"Friday Okonofua, Lorretta Favour Ntoimo, Rosemary Ogu, Maradona Isikhuemen","doi":"10.1080/23288604.2025.2477941","DOIUrl":"10.1080/23288604.2025.2477941","url":null,"abstract":"Diabetes mellitus, once a rare diagnosis in precolonial and early post-colonial Nigeria, now has the highest prevalence and fatality rates in sub-Saharan Africa. This increased prevalence is attributed to rising population affluence characterized by sedentary lifestyles and higher consumption of processed and ultra-processed foods. The burden is further exacerbated by a poorly responsive healthcare system. Currently, less than 50% of affected individuals are aware of their condition. Factors such as misconceptions about the disease, a preference for unproven traditional herbal treatments, and the high cost of treatment hinder effective secondary responses. Health system challenges in diabetes management in Nigeria include inadequate implementation of existing policies and guidelines, high out-of-pocket payments, poor quality of healthcare, and limited public education about the disease. To address these issues, we recommend a policy focus on: 1) Implementing actionable policies and guidelines for diabetes prevention and care; 2) Improving the pre-paid care system to reduce out-of-pocket payments; 3) Enhancing the quality of services at all healthcare levels, with the establishment of centers of excellence for specialized diabetes management; 4) Continuing the training, retraining, motivation, and expansion of the workforce responsible for diabetes care; and 5) Health promotion and health awareness aimed at the public to address inaccurate beliefs and practices about diabetes. Addressing these multifaceted factors will help to reduce the rising incidence of diabetes in Nigeria.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2477941"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving Implementation of NCD Care in Low- and Middle-Income Countries: The Case of Fixed Dose Combinations for Hypertension in Kenya. 改善低收入和中等收入国家非传染性疾病护理的实施：肯尼亚高血压固定剂量联合治疗的案例。

Health systems and reform Pub Date : 2025-12-31 Epub Date: 2025-02-04 DOI: 10.1080/23288604.2024.2448862

Adrianna Murphy, Daniel Mbuthia, Ruth Willis, Benjamin Tsofa, Mary Gichagua, Peter Mugo, Kara Hanson, Michael R Reich

{"title":"Improving Implementation of NCD Care in Low- and Middle-Income Countries: The Case of Fixed Dose Combinations for Hypertension in Kenya.","authors":"Adrianna Murphy, Daniel Mbuthia, Ruth Willis, Benjamin Tsofa, Mary Gichagua, Peter Mugo, Kara Hanson, Michael R Reich","doi":"10.1080/23288604.2024.2448862","DOIUrl":"10.1080/23288604.2024.2448862","url":null,"abstract":"Health systems in low- and middle-income countries face the challenge of addressing the growing burden of non-communicable diseases (NCDs) with scarce resources to do so. There are cost-effective interventions that can improve management of the most common NCDs, but many remain poorly implemented. One example is fixed dose combinations (FDCs) of medications for hypertension. Included in WHO's Essential Medicines List, FDCs combine two or more blood pressure lowering agents into one pill and can reduce burden on patients and the health system. However, implementation of FDCs globally is poor. We aimed to identify health systems factors affecting implementation of evidence-based interventions for NCDs, and opportunities to address these, using the case study of FDCs in Kenya. We conducted semi-structured interviews with 39 policy-makers and healthcare workers involved in hypertension treatment policy and identified through snowball sampling. Interview data were analyzed thematically, using the Access Framework to categorize themes. Our interviews identified factors operating at the global, national, county, and provider levels. These include lack of global implementation guidance, context specific cost-effectiveness data, or prioritization by procurement agencies and clinical guidelines; perceived high cost; poor data for demand forecasting; insufficient budget for procurement of NCD medications; absence of prescriber training and awareness of clinical guidelines; and habitual prescribing behavior and understaffing limiting capacity for change. We propose specific strategies to address these. The findings of this work can inform efforts to improve implementation of other evidence-based interventions for NCDs in low-income settings.","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2448862"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Can a 19^th Century French Medical Debate Provide Guidance on How to Tackle Type 2 Diabetes? 19世纪法国医学辩论能为如何治疗2型糖尿病提供指导吗？

Health systems and reform Pub Date : 2025-12-31 Epub Date: 2025-02-25 DOI: 10.1080/23288604.2025.2464977

Abdo S Yazbeck

引用次数: 0

Rethinking Trust and Public Health Compliance: Introducing a Trust Continuum for Policy and Practice. 重新思考信任和公共卫生合规：为政策和实践引入信任连续体。

Health systems and reform Pub Date : 2025-12-31 Epub Date: 2025-02-11 DOI: 10.1080/23288604.2025.2457239

Ashley Fox, Victoria Y Fan, Heeun Kim, Minah Kang

引用次数: 0

How Health Systems World-wide Fail Type 2 Diabetics. 全球卫生系统如何使2型糖尿病患者失败？

Health systems and reform Pub Date : 2025-12-31 Epub Date: 2025-01-23 DOI: 10.1080/23288604.2024.2437898

Abdo S Yazbeck, Son Nam Nguyen, Maria-Luisa Escobar

引用次数: 0

Ryoichi Sasakawa: Personal Reflections on His Life and Legacy. 笹川良一：对他的人生和遗产的个人反思。

Health systems and reform Pub Date : 2025-05-01 Epub Date: 2025-04-09 DOI: 10.1080/23288604.2025.2468564

Etsuko Kita

引用次数: 0

Introduction to the Special Issue on Global Health History and Japan. 全球健康史与日本特刊导言。

Health systems and reform Pub Date : 2025-05-01 Epub Date: 2025-04-09 DOI: 10.1080/23288604.2025.2484858

Michael R Reich

引用次数: 0

Global Health and Its Limitations: An Historical Perspective. 全球健康及其局限性：一个历史的视角。

Health systems and reform Pub Date : 2025-05-01 Epub Date: 2025-04-09 DOI: 10.1080/23288604.2025.2478681

Jesse B Bump

引用次数: 0

Overview of International Health in Postwar Japan. 战后日本国际卫生概况。

Health systems and reform Pub Date : 2025-05-01 Epub Date: 2025-04-09 DOI: 10.1080/23288604.2025.2475556

Taro Yamamoto

引用次数: 0