Until recently, many global health policies and programs were developed and transformed under the influence of world politics and economics. One example is the primary health care strategy established in a political and social context to enhance the sovereignty and human rights of developing countries. However, the initial ideal had to be abandoned after implementation of the structural adjustment policy derived from the context of growing neoclassical economics. The Integrated Management of Childhood Illness (IMCI) policy was developed entirely based on economical reviews the World Bank initiated. Childhood malnutrition in developing countries remains unresolved due to the politically unequal distribution of food and the strategic selling pressures of multinational food companies. The universal access policy of anti-retrovirus drugs for HIV infection has been impeded by the economical battle for intellectual property rights for the manufacturing and purchasing of these drugs. The World Health Organization's Framework Convention on Tobacco Control was enacted against the marketing strategies of multinational tobacco companies. This paper aims to measure the effects of the intentions of international financing organizations and multinational businesses on the development of global health policies and to discuss the challenges for global health under them.
Introduction Health Sector Reform Program (HSRP) in Egypt started in 1997 to improve equity, efficiency, quality and sustainability of Egyptian health systems. This study aims to review reports and publications regarding HSRP in Egypt and to analyze its achievements and problems. Methods Documents of international organizations and other relevant agencies, such as reports of health sector reform programs and statistics, were reviewed and analyzed. Results HSRP aimed to improve quality of health services and equality of access, and to establish sustainable health financing mechanisms, while focusing on primary health care. Major components of HSRP were: health service delivery, health financing, and evaluation. It started in five pilot governorates. Based on the Family Health Model (FHM), each family registered to a physician or a health facility, and was provided with essential medical services called Basic Benefits Package (BBP). Family Health Fund (FHF), the newly established financing agency of FHM, provided health staff with incentives from a pooled fund. Against the original plan, FHF could not function as a health insurance fund, and was financially unsustainable. Mechanisms of health facility accreditation and health services performance evaluation with incentives were installed to ensure the quality of health services. In addition, health staff training programs were enhanced, health facilities and equipment in rural areas were improved, and referral systems were strengthened. Conclusions HSRP introduced a family health model for the first time in Egypt in pilot governorates. Focusing basic health service provision, HSRP succeeded to improve equity, efficiency and quality of health services. However, sustainable health insurance mechanisms were not established yet, and involvement of private health service providers were very limited. It is needed to bring in commitment of Egyptian government across the sectors and to develop health systems that secure good quality of health services for all Egyptians.
Images of the concepts of “International Health” and “International Nursing” may differ among countries. In this study, we examined the images of these concepts among 49 Fijian students, 85 Taiwanese students, and 377 Japanese students by self-administered questionnaire between 2007 and 2008. Full usable responses were received from 45 (91.8%) Fijian students, 69 (80.0%) Taiwanese students, and 352 (93.4%) Japanese students. The results were as follows. Ninety six percent of Japanese nursing students, 89% of Japanese medical students, 77% of Japanese student from four other faculties, 58% of Fijian students, and 26% of Taiwanese students reported their image of “International Health” to entail “Hygiene in developing countries”. Ninety-two percent of Japanese nursing students, 92% of Japanese medical students, 40% of Fijian students, and 35% of Taiwanese students reported their image of “International Nursing” to entail “Nursing cooperation in developing countries”. The images of “International Health” and “International Nursing” among the Fijian and Taiwanese students were of“Public health and nursing for foreigners living in Fiji or Taiwan”, and “Public health and nursing skills, and advanced medical systems in Westerns countries”. Most students in the three countries had a strong interest in-International Health and Nursing”. Increasing chance of taking international information and knowledge of Japanese college students may influence the result of this study. Education and rearing students who will work in the field of international health was considered very important.
Summarized in the following are lessons and recommendations gained through the three-year project on -Strengthening of Malaria Control in Solomon Islands”. The poor quality of malaria services and people's lack of access to proper services remain as a tremendous obstacle in developing countries. In areas remote from the central town, both morbidity and mortality from malaria tend to be higher than those in the central area. The concern shared by many living in such remote areas is how to prevent severe cases of malaria. Recommendations for malaria-related strategies in the isolated area include (1) fostering the capacity of the community to respond to severe cases of malaria through strengthening the key health facility in the malaria management (2) having the community residents themselves to have the ownership of the activities, and constructing malaria control for the community by the community. Nevertheless, it has been recognized that creating a malaria control guideline as well as its complete implementation is not enough to achieve the objectives. The guideline simply provides a standard or a benchmark, and it is, above all, not only flexible but also sensible and timely decisions suited to each circumstance, as well as actions backed by a strong sense of mission that, in the end, save the lives of malaria patients. In addition, if self-help efforts in the country are to be expected, it is of foremost importance to train healthcare workers and reserve officers.
Introduction One of the challenges related to global health is the imbalanced distribution of health professionals and the HIV/AIDS pandemic. Under this situation, the importance of HIV/AIDS care with health volunteers has been recognized, especially in developing countries, which suffer from the double burden. A task shifting approach is encouraged among health professionals, as well as, between health professionals and non health professionals. Objective To discuss supportive surroundings for sustainable HIV/AIDS care with heath volunteers from the perspective of motivation. Methods A literature review, where articles were searched and extracted through the PubMed database, was conducted in May, 2010. In total, 16 combinations with 11 keywords were used for searching. (First keyword: motivation, second keyword: HIV or AIDS, third keyword: community health aides, community health workers, community workers, lay counselors, adherence support workers, adherence counselors, care givers or volunteers) Results Among the 290 articles extracted, nine articles meeting the criteria of this literature review were selected. Eight articles were reported from developed countries and one article was from a developing country. About half of the study participants in six articles were People With HIV (PWH) or homosexuals. Through all articles, “altruism” and “self development” were recognized as motivation for health volunteers to join and maintain activities. Especially for continuity of activities, “support from other members and staff” and “recognition” were raised. Specific motivation from a developing country was the “ step to formal employment”. Discussion and Conclusion Regardless of developed- or developing- countries, fundamental motivation of health volunteers for HIV/AIDS care is similar. However, in developing countries, where health volunteers are adopted as part of the health system, adequate and continuous support and supervision are required more than in developed countries for sustainability of stable care provision. PWH can, also, play an active role as HIV/AIDS care providers by themselves, and they will be a key component for HIV/AIDS care. Further exploration is necessary to determine the motivation of health volunteers for HIV/AIDS care in developing countries where a task shifting approach is encouraged under a shortage of health professionals and HIV/AIDS epidemic.