Article
Health Care Sciences & Services
Kevin Croke, Osondu Ogbuoji
Summary: Nigeria has made efforts to strengthen primary health care and move towards universal health care through initiatives such as Saving One Million Lives (SOML) and the National Health Act. However, political and institutional challenges have hindered the implementation and sustainability of these programs. The study analyzes these challenges from a political economy perspective, highlighting barriers to adoption and implementation throughout the policy cycle.
HEALTH POLICY AND PLANNING
(2023)
Article
Health Care Sciences & Services
Diksha Singh, Shankar Prinja, Pankaj Bahuguna, Akashdeep Singh Chauhan, Lorna Guinness, Sameer Sharma, P. V. M. Lakshmi
Summary: The study assessed the cost of transforming current primary healthcare facilities in India to health and wellness centers, revealing the need for an additional allocation of $10178 million from 2019 to 2023 for the scale-up. The findings suggest an increase in the Government of India's health budget from 2.5% in 2019 to 12.1% in 2023. It is recommended to pay providers between $4.70 and $3.57 per person covered for provision of comprehensive primary health care services with a capitation-based payment system.
HEALTH POLICY AND PLANNING
(2021)
Review
Multidisciplinary Sciences
Daniel Erku, Resham Khatri, Aklilu Endalamaw, Eskinder Wolka, Frehiwot Nigatu, Anteneh Zewdie, Yibeltal Assefa
Summary: Community engagement is crucial in primary health care, and there is a growing need for service providers to involve communities in the planning, design, delivery, and evaluation of services. This scoping review explores the attributes, contexts, and mechanisms of community engagement initiatives in improving primary health care service delivery and achieving universal health coverage. The review highlights the potential role of community engagement in decision making and overall health outcomes, as well as the organizational, cultural, political, and contextual factors that influence the success of these initiatives in primary health care settings.
Article
Health Care Sciences & Services
Karl Rubio, Taressa K. Fraze, Salma Bibi, Hector P. Rodriguez
Summary: This study examines whether primary care practices serving high proportions of Black or Latino Medicare fee-for-service beneficiaries are less likely to participate in the CPC+ program. The results show that practices with relatively high proportions of Black and Latino beneficiaries are less likely to participate in CPC+ compared to practices with lower proportions. State differences partially explain participation disparities for practices with high proportions of Black beneficiaries, but do not explain disparities for practices with high proportions of Latino beneficiaries.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2023)
Article
Public, Environmental & Occupational Health
Anuja Jayaraman, Armida Fernandez
Summary: The role of civil society in primary health care delivery is well-established. During the pandemic, civil society not only helped vulnerable populations mitigate challenges but also filled gaps in India's health care system. This paper aims to strengthen primary health care and achieve universal health coverage from the perspective of civil society. Civil society organizations connect with hard-to-reach populations, build capacity of frontline staff, recommend attitude and motivation changes, fill gaps in the system, and refer people to appropriate health facilities.
FRONTIERS IN PUBLIC HEALTH
(2023)
Article
Public, Environmental & Occupational Health
Teri Reynolds, Thomas Wilkinson, Melanie Y. Bertram, Matthew Jowett, Rob Baltussen, Awad Mataria, Ferozuddin Feroz, Mohamed Jama
Summary: As no country or health system can provide all possible health services, prioritizing a subset of services for universal availability is integral to universal health coverage. However, creating a package of priority services alone is not enough; implementation is crucial for their impact. There are tensions between criteria-driven prioritization and implementation-oriented formulations, and service delivery considerations are often overlooked. Bridging the gap from a package of services to actual delivery presents challenges for countries. Failure to incorporate delivery considerations during prioritization and design stages can undermine the goals of service delivery. Drawing from country experiences, we discuss choices in package structure and content, and propose ideas to build more implementable service packages to effectively bridge the gap between intent and implementation.
Article
Public, Environmental & Occupational Health
Ramiro E. Gilardino, Pilar Valanzasca, Susan B. Rifkin
Summary: Argentina, Brazil, Colombia and Mexico have made progress towards achieving Universal Health Coverage, but better financial protection mechanisms are urgently needed.
ARCHIVES OF PUBLIC HEALTH
(2022)
Review
Medicine, General & Internal
Sjan-Mari van Niekerk, Sureshkumar Kamalakannan, Gakeemah Inglis-Jassiem, Maria Yvonne Charumbira, Silke Fernandes, Jayne Webster, Rene English, Quinette A. Louw, Tracey Smythe
Summary: This study explores the opportunities and challenges within the health system to achieve universal health coverage for people with stroke in South Africa. It highlights certain areas that show promising trends to improve service delivery, such as comprehensiveness, quality, and perceptions of care.
Article
Health Care Sciences & Services
Christine Walker, Chris L. Peterson
Summary: Sturmberg and Martin argue that universal health coverage is mainly about financing, while primary health care is about providing the right care at the right time. They emphasize the importance of understanding political economy in addressing health inequities and the socio-political issues involved in managing care for various illnesses. Out-of-pocket costs in countries like Australia have grown rapidly, affecting access to primary health care and challenging the notion of equity in universal health coverage.
JOURNAL OF EVALUATION IN CLINICAL PRACTICE
(2021)
Article
Public, Environmental & Occupational Health
Andres Lopez Cabello
Summary: Universal Health Coverage (UHC) is a hegemonic concept in international health system reforms, aimed to provide health goods and services for the poor but may also contribute to health system fragmentation. It may be comprehended as a new facet of neoliberalism, with states mainly playing a role of public funds administrators.
GLOBAL PUBLIC HEALTH
(2021)
Review
Health Care Sciences & Services
Thanos Myloneros, Dikaios Sakellariou
Summary: The Primary Health Care reforms in Greece have not significantly improved Universal Health Coverage, despite some positive steps taken with the establishment of community-based multidisciplinary health teams. An evidence-based monitoring and evaluation mechanism is necessary before further interventions are implemented.
BMC HEALTH SERVICES RESEARCH
(2021)
Article
Public, Environmental & Occupational Health
Clelia D'Apice, Luca Ghirotto, Maria C. Bassi, Giovanna Artioli, Leopoldo Sarli
Summary: The study identified staff-based interventions that impact Universal Health Coverage through Primary Health Care, including culturally sensitive ad hoc bridge figures, tailoring staff practices to specific populations' needs, and training for staff reskilling. Context and contextual factors are crucial for the success of these interventions as they aim to reach UHC within the given context. Healthcare bridge figures, trained to respond to local societal and cultural norms, play a key role in increasing access to PHC services by ensuring community acceptance and ownership.
JOURNAL OF GLOBAL HEALTH
(2022)
Review
Public, Environmental & Occupational Health
Leila Doshmangir, Mohammad Bazyar, Arash Rashidian, Vladimir Sergeevich Gordeev
Summary: The healthcare reforms in Iran have made progress towards universal health coverage (UHC) and health equity by expanding population coverage, enhancing benefits, and improving financial protection. However, challenges such as collecting contributions, incomplete implementation of laws, and controlling healthcare expenditures still remain.
INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH
(2021)
Article
Public, Environmental & Occupational Health
Xiaoyun Liu, Ziyue Wang, Huan Zhang, Qingyue Meng
Summary: This study developed a Chinese version of Universal Health Coverage indices and measured China's progress towards UHC through accessibility and affordability indices. The research found that China has made significant progress in improving the accessibility and affordability of health services since the health system reforms in 2009.
JOURNAL OF GLOBAL HEALTH
(2021)
Article
Biochemistry & Molecular Biology
Stephane Verguet, Alemayehu Hailu, Getachew Teshome Eregata, Solomon Tessema Memirie, Kjell Arne Johansson, Ole Frithjof Norheim
Summary: All countries worldwide have signed up to the United Nations Sustainable Development Goals and committed to the objective of achieving universal health coverage. Getting there will require understanding how packages of essential health services can be developed in resource-constrained settings and how experts and the public can make decisions about which health services should be provided free of charge.
Article
Public, Environmental & Occupational Health
Ligia Giovanella, Aylene Bousquat, Simone Schenkman, Patty Fidelis de Almeida, Luciana Monteiro Vasconcelos Sardinha, Maria Lucia Franca Pontes Vieira
Summary: Brazil's Family Health Strategy has seen an increase in coverage over the past few years, but the frequency of monthly health worker visits has decreased. The highest coverage is generally found among the most vulnerable population. Those enrolled in Family Health Clinics tend to have more options for their usual source of care.
CIENCIA & SAUDE COLETIVA
(2021)
Article
Public, Environmental & Occupational Health
Itamar Bento Claro, Luciana Dias de Lima, Patty Fidelis de Almeida
Summary: Chile has a well-structured program with centralized decision-making and monitoring system, while Brazil faces challenges with lack of coordination and follow-up for women with abnormal test results in cervical cancer screening. Both countries need to improve coverage and implement organized screening.
CIENCIA & SAUDE COLETIVA
(2021)
Article
Public, Environmental & Occupational Health
Suelen Carlos de Oliveira, Cristiani Vieira Machado, Alex Rene Alarcon Hein, Patty Fidelis de Almeida
Summary: The article analyzes the configuration of public-private relations in Chile's health system between 2000 and 2018, highlighting issues with organization and regulation, funding, and service delivery. Despite implementation of strategies, the segmentation of the system persists along with problems related to access to private services and sustainability of the funding model. The nature of public-private relations reinforces population segmentation and structural changes in the health system remain elusive despite reforms implemented during the study period.
CIENCIA & SAUDE COLETIVA
(2021)
Article
Public, Environmental & Occupational Health
Herlan Palacios-Perdomo, Naydu Acosta-Ramirez
Summary: Adolescent pregnancy in rural areas is a persisting health issue that lacks proper understanding, with limited qualitative studies addressing it as a complex social process. This research in Colombia explored the social determinants of adolescent pregnancy in the Amaime river basin, revealing issues such as social stigma, lack of sex education, and sociocultural influences on behaviors. The study contributes to sexual and reproductive health interventions by providing analytical insights into the social dimensions of the issue.
INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH
(2021)
Article
Public, Environmental & Occupational Health
Natalia Chavez Narvaez, Naydu Acosta-Ramirez
Summary: The study aims to understand the impact of experiencing extreme maternal morbidity (EMM) on the meanings of life and daily life reconstruction. Participants perceive EMM as a suffering that is worthwhile and construct meanings from each stage of the experience. Women's perception of quality of life depends on both the experience itself and social support, as well as the survival of the baby. The role of health services is critical in alleviating loneliness, worry, and stress by providing compassionate care.
CIENCIA & SAUDE COLETIVA
(2022)
Article
Public, Environmental & Occupational Health
Patty Fidelis de Almeida, Kamilla Santos Silva, Aylene Bousquat
Summary: The aim of this study was to analyze the organization and provision of specialized care and health transport in regional polyclinics in Bahia, Brazil. The study identified advances and challenges, including an increase in the provision of specialized care and improvements in the quality of services, as well as the need to tailor specialized care planning to regional health needs.
CIENCIA & SAUDE COLETIVA
(2022)
Article
Public, Environmental & Occupational Health
Marcia Cristina Rodrigues Fausto, Patty Fidelis de Almeida, Aylene Bousquat, Juliana Gagno Lima, Adriano Maia dos Santos, Helena Seidl, Maria Helena Magalhaes de Mendonca, Lucas Manoel da Silva Cabral, Ligia Giovanella
Summary: Despite socio-spatial diversity, remote rural areas in Brazil face similar challenges such as scattered small villages, isolated populations, and lengthy distances from urban centers. This study aimed to analyze the unique characteristics of organizing and accessing primary health care (PHC) in the Brazilian National Health System (SUS) within remote rural municipalities (MRR). Through qualitative research methods, including multiple case studies and thematic content analysis of interviews with managers and health professionals, the study identified the impact of remote rural contexts on PHC provision, differences in health service delivery, challenges in areas with sparse populations and long distances, funding contradictions, and workforce shortages. The findings underscore the need for public policies that consider the territorial, social, and access characteristics to address the healthcare needs of MRR.
Article
Public, Environmental & Occupational Health
Marcia Cristina Rodrigues Fausto, Patty Fidelis de Almeida, Aylene Bousquat, Juliana Gagno Lima, Adriano Maia dos Santos, Helena Seidl, Maria Helena Magalhaes de Mendonca, Lucas Manoel da Silva Cabral, Ligia Giovanella
Summary: The study aims to analyze the organization and access to primary health care (PHC) in remote rural municipalities (MRR) in Brazil. A qualitative study was conducted using a multiple case study approach in 27 MRR. Thematic content analysis of 211 semi-structured interviews with managers and health professionals revealed the specificities and challenges of PHC in these areas. The findings highlight the impact of remote rural contexts on PHC provision, differences in healthcare coverage, contradictions between national funding and local characteristics, and workforce shortages as common challenges.
Article
Public, Environmental & Occupational Health
Patty Fidelis de Almeida, Elisete Casotti, Rafaela Fidelis Lima Silverio
Summary: This study analyzes the use of and access to the healthcare network by COVID-19 patients in Niteroi, Brazil. The study findings indicate that TV newscasts were the main source of information about COVID-19, preventive hygiene measures were widely adopted, and the family served as the primary support network. However, there was a lack of post-discharge care and a need for improved primary health care and specialized public services and rehabilitation.
CADERNOS DE SAUDE PUBLICA
(2023)
Letter
Public, Environmental & Occupational Health
Gulnar Azevedo e Silva, Itamar Bento Claro, Jeane Glaucia Tomazelli, Caroline Madalena Ribeiro, Vania Reis Girianelli, Patty Fidelis de Almeida, Luciana Dias de Lima
CADERNOS DE SAUDE PUBLICA
(2022)
Article
Public, Environmental & Occupational Health
Gulnar Azevedo e Silva, Luciana Leite de Mattos Alcantara, Jeane Glaucia Tomazelli, Caroline Madalena Ribeiro, Vania Reis Girianelli, Ednei Cesar Santos, Itamar Bento Claro, Patty Fidelis de Almeida, Luciana Dias de Lima
Summary: This study analyzes the performance of cervical cancer screening and diagnosis tests among women aged 25 to 64 in Brazil, as well as the delay in treatment initiation. The study found significant regional variations in screening coverage and a downward trend in recent years. There was also a discrepancy between recorded cancer diagnoses and estimated cases, and variations in the percentage of women experiencing treatment delays.
CADERNOS DE SAUDE PUBLICA
(2022)
Article
Public, Environmental & Occupational Health
Juliana Gagno Lima, Ligia Giovanella, Mdrcia Cristina Rodrigues Fausto, Patty Fidelis de Almeida
Summary: The study analyzed the work process of community health agents in remote rural municipalities, identifying a comprehensive scope of practices and the critical role of home visits. ACS in remote rural communities play an important role in providing care, facilitating population's access to healthcare, and acting as a vital link between rural populations and health services in remote rural areas.
CADERNOS DE SAUDE PUBLICA
(2021)
Article
Public, Environmental & Occupational Health
Livia dos Santos Mendes, Patty Fidelis de Almeida, Adriano Maia dos Santos, Isabella Chagas Samico, Jessica Prates Porto, Maria-Luisa Vazquez
Summary: The study found limited coordination between primary healthcare and specialized care in a medium-sized Brazilian city's public health system, with insufficient information sharing. Temporary employment contracts are more common in primary healthcare, lack of communication and coordination among physicians, and long waiting times for consultations are also issues present.
CADERNOS DE SAUDE PUBLICA
(2021)
Article
Public, Environmental & Occupational Health
Aylene Bousquat, Maria Guadalupe Medina, Maria Helena Magalhaes de Mendonca, Patty Fidelis de Almeida, Rosana Aquino, Alaneir de Fatima dos Santos, Ligia Giovanella
CIENCIA & SAUDE COLETIVA
(2020)
Article
Public, Environmental & Occupational Health
Ligia Giovanella, Cassiano Mendes Franco, Patty Fidelis de Almeida
CIENCIA & SAUDE COLETIVA
(2020)