Health systems and reformPub Date : 2025-05-01Epub Date: 2025-04-09DOI: 10.1080/23288604.2025.2468564
Etsuko Kita
{"title":"Ryoichi Sasakawa: Personal Reflections on His Life and Legacy.","authors":"Etsuko Kita","doi":"10.1080/23288604.2025.2468564","DOIUrl":"https://doi.org/10.1080/23288604.2025.2468564","url":null,"abstract":"","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 2","pages":"2468564"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030112","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}
Health systems and reformPub Date : 2025-05-01Epub Date: 2025-04-09DOI: 10.1080/23288604.2025.2484858
Michael R Reich
{"title":"Introduction to the Special Issue on Global Health History and Japan.","authors":"Michael R Reich","doi":"10.1080/23288604.2025.2484858","DOIUrl":"https://doi.org/10.1080/23288604.2025.2484858","url":null,"abstract":"","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 2","pages":"2484858"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046000","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}
Health systems and reformPub Date : 2025-05-01Epub Date: 2025-04-09DOI: 10.1080/23288604.2025.2478681
Jesse B Bump
{"title":"Global Health and Its Limitations: An Historical Perspective.","authors":"Jesse B Bump","doi":"10.1080/23288604.2025.2478681","DOIUrl":"https://doi.org/10.1080/23288604.2025.2478681","url":null,"abstract":"<p><p>Humanitarian themes, such as rights and entitlements to universal well-being, feature prominently in narratives of global health, even as many recent authors have pointed to systematic imbalances of power, unfair governance structures, and unwanted influences as evidence of ongoing colonial interference in the health affairs of many low- and middle-income countries. This article employs an historical perspective to analyze major forces that have shaped the development of global health, and which remain as obstacles to its objectives. These include macroeconomics, geopolitics, and the activism and resources of the HIV/AIDS pandemic that led to global health in its current form. Through an examination of this history and its effects, I argue that the humanitarian goals of global health will not be realized without dramatic changes to the field. Particularly in the failure to engage economic relationships and trade policy, global health limits its attention to downstream consequences of resource inequalities, where its goal of a more egalitarian, more healthy world is difficult, if not impossible, to achieve.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 2","pages":"2478681"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061315","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}
Health systems and reformPub Date : 2025-05-01Epub Date: 2025-04-09DOI: 10.1080/23288604.2025.2475556
Taro Yamamoto
{"title":"Overview of International Health in Postwar Japan.","authors":"Taro Yamamoto","doi":"10.1080/23288604.2025.2475556","DOIUrl":"https://doi.org/10.1080/23288604.2025.2475556","url":null,"abstract":"<p><p>This commentary traces the emergence and evolution of international cooperation in the medical and public health fields in postwar Japan. It examines how trends in the nature of its international cooperation efforts reflected economic and social trends over three time periods between the end of World War II and the end of the twentieth century. In the first period, Japan's approach to international cooperation was both limited and influenced by its own reconstruction. In the second period, Japan sought to reenter the international community by making contributions towards world peace and international health. In the third period, Japan's remarkable economic growth enabled it to become a major source of overseas development assistance around the world. The paper includes short profiles of eight Japanese innovators in international health cooperation (and mentions numerous others who were similarly active in the field). Over the years, these and many other individuals built Japanese international health agencies and shaped the country's changing approaches to international health.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 2","pages":"2475556"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044116","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}
Health systems and reformPub Date : 2024-12-31Epub Date: 2024-06-14DOI: 10.1080/23288604.2024.2352885
Elina Dale, Julia Novak, Denys Dmytriiev, Olga Demeshko, Jarno Habicht
{"title":"Resilience of Primary Health Care in Ukraine: Challenges of the Pandemic and War.","authors":"Elina Dale, Julia Novak, Denys Dmytriiev, Olga Demeshko, Jarno Habicht","doi":"10.1080/23288604.2024.2352885","DOIUrl":"10.1080/23288604.2024.2352885","url":null,"abstract":"<p><p>This commentary examines the resilience of primary health care in Ukraine amidst the ongoing war, drawing a few reflections relevant for other fragile and conflict-affected situations. Using personal observations and various published and unpublished reports, this article outlines five reflections on the strengths, challenges, and necessary adaptations of Primary Health Care (PHC) in Ukraine. It underscores the concerted efforts of the government to maintain public financing of PHC, thereby averting system collapse. The research also highlights the role of strategic adaptations during the COVID-19 pandemic in fostering resilience during the war, including the widespread use of digital communication and skills training. The commentary emphasizes the role of managerial and financial autonomy in facilitating quick and efficient organizational response to crisis. It also recognizes emerging challenges, including better access to PHC services among the internally displaced persons, shifting patient profiles and service needs, and challenges related to reliance on local government financing. Finally, the authors advocate for a coordinated approach in humanitarian response, recovery efforts, and development programs to ensure the sustainability and effectiveness of PHC in Ukraine.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"10 1","pages":"2352885"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141322051","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}
{"title":"The Impact of Centralized Procurement on Treatment Patterns for Myocardial Infarction and More Principled Utilization of Coronary Stents.","authors":"Weiyan Jian, Shanshan Huo, Lanyue Zhang, Wuping Zhou","doi":"10.1080/23288604.2024.2366167","DOIUrl":"10.1080/23288604.2024.2366167","url":null,"abstract":"<p><p>Reducing the price of expensive medical products through centralized procurement is generally considered an effective way to save public medical resources. Against this background, this paper presents an analysis of the impact of centralized procurement in China by comparing the treatment costs and patterns for acute myocardial infarction (AMI) patients before and after the introduction of this method of purchasing, with specific reference to the use of coronary stents. We found that, after the implementation of centralized procurement for coronary stents, the total expenditure of AMI cases receiving percutaneous coronary interventions with stent implantation (PCI with stents) dropped by 23.4%. The use rate of PCI with stents decreased by 32.5%, with the most significant decrease being evident in cases in which two stents were used simultaneously (32.9%). Meanwhile, percutaneous coronary interventions with balloon implantation (PCI with balloons) increased by 31.5% and coronary artery bypass grafting (CABG) increased by 80.3%. Based on these patterns, it can be observed that the use of centralized procurement significantly reduced the profits of the relevant medical manufacturers, forcing them to decrease their marketing investments, weakening their influence on providers, and ultimately resulting in a more principled use of coronary stents. We therefore conclude that, with reference to the data cited, the centralized procurement program led not only to a reduction in procurement prices but also to decreased overuse of these expensive medical products.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"10 1","pages":"2366167"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437887","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}
Health systems and reformPub Date : 2024-12-31Epub Date: 2024-01-29DOI: 10.1080/23288604.2023.2298652
Eriko Sase, Christopher Eddy, Richard J Schuster
{"title":"COVID-19 Deaths in Long-Term Care Facilities in the US: An Urgent Call for Equitable and Integrated Health Systems and an All-Hazards Approach to the Next Crisis.","authors":"Eriko Sase, Christopher Eddy, Richard J Schuster","doi":"10.1080/23288604.2023.2298652","DOIUrl":"10.1080/23288604.2023.2298652","url":null,"abstract":"","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"10 1","pages":"2298652"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139577183","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}
{"title":"Does Public Financial Management Save Life? Evidence from a Quantitative Review of PFM and Health Outcomes in Sub-Saharan African Countries.","authors":"Yann Tapsoba, Amna Silim, Kingsley Addai Frimpong, Hélène Barroy","doi":"10.1080/23288604.2023.2298190","DOIUrl":"10.1080/23288604.2023.2298190","url":null,"abstract":"<p><p>Public financial management (PFM) theory suggests that improvements in the allocation, execution, and monitoring of public funds can result in improved sectoral outcomes, including in health. However, the existing literature on the relationship between PFM quality and health outcomes provides limited empirical documentation and insufficient explanation of the mechanics of that relationship. This paper contributes to the literature by estimating the correlation between PFM quality and health outcomes from a sample of sub-Saharan African countries over the period 2005-2018, using a pooled ordinary least squares (OLS) estimator. The analysis uses Public Expenditure and Financial Accountability (PEFA) scores as proxies for PFM quality. The findings indicate that countries with high-quality PFM tended to have the lowest maternal, under-five and noncommunicable diseases (NCDs) mortality. Among the standard PFM dimensions, the one associated with the higher correlation with maternal and under-five mortality was \"<i>predictability and control in budget execution</i>.\" Better PFM quality was significantly associated with a drop in maternal and under-five mortality in countries which allocated a higher proportion of their budget to the health sector. In countries allocating a lower proportion of their budget to health, the correlations between PFM quality and the three mortality indicators were not significant. The negative correlations between PFM quality and maternal and under-five mortality were significant only in countries with more effective governance. These findings support an emphasis on strengthening PFM as a means of improving health service provision and health outcomes.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"10 1","pages":"2298190"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139473124","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}
Health systems and reformPub Date : 2024-12-18Epub Date: 2025-01-08DOI: 10.1080/23288604.2024.2441533
Obinna Onwujekwe, Uchenna Ezenwaka, Prince Agwu, Chukwudi Nwokolo, Francis Ukwuije, Alexandra J Earle, Agnes Gatome-Munyua, Susan Sparkes
{"title":"Assessing Root Causes and Solutions to Address Cross-Programmatic Inefficiencies in a Subnational Health System: A Case Study of Anambra State, Nigeria.","authors":"Obinna Onwujekwe, Uchenna Ezenwaka, Prince Agwu, Chukwudi Nwokolo, Francis Ukwuije, Alexandra J Earle, Agnes Gatome-Munyua, Susan Sparkes","doi":"10.1080/23288604.2024.2441533","DOIUrl":"10.1080/23288604.2024.2441533","url":null,"abstract":"<p><p>Cross-programmatic inefficiencies are duplications or misalignments that arise from undue fragmentation of health systems by vertical health programs. Identifying and addressing the root causes of cross-programmatic inefficiencies in a health system can ensure more efficient use of resources to make progress toward Universal Health Coverage. This paper examines the root causes of cross-programmatic inefficiencies related to governance and financing in the state health system of Anambra in southeast Nigeria. Data were collected from 38 in-depth interviews and four focus group discussions and analyzed thematically. The governance- and finance-related cross-programmatic inefficiencies identified were duplicative and misaligned roles within and between state and federal agencies, functions, and activities within and across health programs; misaligned donor priorities with that of the state; and poor formulation and implementation of the approved annual state health budget. The root causes of governance and financing cross-programmatic inefficiencies included weak policy development, communication, and enforcement; excessive influence of external donors and the federal government; weak accountability mechanisms affecting program coordination and service delivery; and a disharmony between state priorities and objectives with planning, budgeting, and execution of the budget. Addressing the root causes of cross-programmatic inefficiencies has the potential to significantly improve the overall efficiency and performance of the health system to contribute to improved health outcomes in Anambra state. This approach can serve as a model for other states and regions facing similar challenges.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"10 3","pages":"2441533"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959731","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}
Health systems and reformPub Date : 2024-12-18Epub Date: 2024-11-12DOI: 10.1080/23288604.2024.2397829
Pura Angela Co, Ileana Vîlcu, Denese De Guzman, Eduardo Banzon
{"title":"Staying the Course: Reflections on the Progress and Challenges of the UHC Law in the Philippines.","authors":"Pura Angela Co, Ileana Vîlcu, Denese De Guzman, Eduardo Banzon","doi":"10.1080/23288604.2024.2397829","DOIUrl":"https://doi.org/10.1080/23288604.2024.2397829","url":null,"abstract":"<p><p>The Philippine Universal Health Care (UHC) law enacted in 2019 aimed to address entrenched health system challenges to achieving equitable access to quality health care. This commentary discusses the progress in its implementation to meet its objectives. Some of these health system challenges include overlapping financing roles; weak incentives for integrating health services across local government units (LGUs), the inclusion of the private sector in networks of care, and fragmented primary health care services. The UHC law introduced reforms to transform the Philippine Health Insurance Corporation (PhilHealth) into a strategic purchaser of health services, expand population coverage, and prioritize comprehensive outpatient and primary care services. Furthermore, the law mandated bolstering subnational health financing through a Special Health Fund (SHF) intended to encourage LGUs to integrate into provincial or city health systems. Pilots of the SHF highlighted opportunities and challenges in pooling, prioritizing, and redistributing resources if local health systems are capacitated. Despite facing implementation challenges, including changing priorities, politics, and lack of resources, the Philippines' experience emphasizes the importance of adaptive leadership, sustained commitment, and effective stakeholder engagement to ensure that these health financing reforms remain objective-oriented. Maximizing the UHC law's potential going forward requires addressing ongoing challenges: sustained resource generation, ensuring effective coverage of the poor, and capacitating local health systems. The journey of the Philippines toward UHC offers valuable insights for global health reformers, underscoring the need for adaptive approaches and active political engagement to sustain and achieve progress toward universal and equitable health care access.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"10 3","pages":"2397829"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634217","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}