Bulletin of the World Health Organization

Articles from Vol. 84, No. 11, November

Contracting and Health
David Evans earned his PhD in economics from the Australian National University in 1980. He started his academic career in the economics and medical faculties at universities in Singapore and his native Australia. During this time, he specialized in...
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Contracting but Not without Caution: Experience with Outsourcing of Health Services in Countries of the Eastern Mediterranean Region/Externaliser, Mais Avec Prudence: Experience Acquise Dans le Domaine Des Prestations De Sante Dans Certains Pays De la Region Mediterranee orientale/Contratar, Pero Con Prudencia: Experiencia De Externalizacion De Servicios De Salud En Paises De la Region del Mediterraneo Oriental
Introduction Contracting is being increasingly used by the public sector in developing countries for the purchase of specified services from the private sector, (1-5) and in some developed countries through internal contracts with autonomous public...
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Contracting in Practice: A Low- and Middle-Income Perspective
The above paper by Perrot is opportune. Many low-income and middle-income countries promote the use of contract, as opposed to direct provision by the public sector, as one of their health reform approaches--part of the "purchaser--provider split."...
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Contracting Is Not an End in Itself
Jean Perrot sheds valuable light on the conceptual relationships between contracting and privatization. This stimulating methodical clarification is welcome on questions where semantic confusion runs rife, undermining the quality of cooperation between...
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Different Approaches to Contracting in Health systems/La Diversite Du Recours a la Contractualisation Dans Les Systemes De sante/Diferentes Sistemas De Contratacion En Los Sistemas De Salud
Contractual relations based on delegation of responsibility Contractual relations based on delegation of responsibility are set up so that rather than directly managing the health services it owns or undertaking to develop health coverage itself,...
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Hard Gains through Soft Contracts: Productive Engagement of Private Providers in Tuberculosis control/Engagement Productif Des Prestateurs Prives Dans la Lutte Antituberculeuse: Des Benefices Bien Reels Sans Contrat leonin/Ventajas De Los Contratos Relacionales: Contratacion Productiva De Proveedores Privados En la Lucha Contra la Tuberculosis
Introduction Private health care providers play a prominent role in delivering curative services in the majority of low-income countries. (l-5) They are often the first point of contact for a large number of rich and poor patients and manage a significant...
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Health-Care Patents and Interests of Patients
Editor--I wish to congratulate Anatole Krattiger & Richard T. Mahoney on their editorial in the May issue of the Bulletin. (1) As they point out, "Developing health technologies for the world's poor people increasingly requires the wise management...
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Health Impact Assessment and Health Promotion
Introduction The Bangkok Charter on Health Promotion in a Globalized World, adopted at the Sixth Global Conference on Health Promotion in August 2005 (http://www. who.int/healthpromotion/conferences/ 6gchplbangkok_charter/en/), highlights the role...
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Is Contracting a Form of privatization?/La Contractualisation Est-Elle Une Forme De privatisation?/La Contratacion: ?Una Forma De Privatizacion?
It is common for contracting to be seen as a form of privatization. When it ceases to provide health services, the state contributes instead to the privatization of the health sector. Contracts are generally seen as the tool that makes privatization...
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Knowledge Gaps in Scientific Literature on Maternal Mortality: A Systematic review/Lacunes De la Litterature Scientifique Sur la Mortalite Maternelle Mises En Evidence Par Une Revue Systematique De Cette litterature/Lagunas En Las Publicaciones Cientificas Sobre la Mortalidad Materna: Revision Sistematica
Introduction Much empirical and theoretical information exists on the various causes of maternal death. However, despite the amount of published work on this problem, maternal mortality remains high in many parts of the world and the solutions remain...
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Maternal Health Care Wins District Vote in Uganda: One District in Uganda Has Dramatically Reduced the Number of Womens' Deaths Due to Pregnancy and Childbirth. Now the Government Is Considering How to Extend the Same Level of Maternal Care to Women to the Country's Remaining 75 Districts
When Dr Godfrey Egwau, a consultant obstetrician at Soroti Regional Referral Hospital's maternity unit, stood for parliament in February, voters knew that if he won he would move to the capital, Kampala, about 280 km away. Women in Soroti district...
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Pakistan, Afghanistan Look to Women to Improve Health Care: Women Health Workers Have Been Vital in Improving the Health of Women and Children in Pakistan. Inspired by Its Neighbour's Experience, Afghanistan Is Embarking on a Similar Programme to Encourage Women to Work in the Health Sector
Khalda Perveen ventures where trained doctors rarely dare to go. She is among more than 90 000 Lady Health Workers who are working to increase health awareness and improve child and maternal health across Pakistan, particularly in poor rural areas...
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Performance-Based Financing and Changing the District Health System: Experience from Rwanda/Financement En Fonction Des Resultats et Modification Du Systeme De Sante De District: Experimentation Au Rwanda/Financiacion Basada En El Rendimiento Y Cambios En El Sistema De Salud De Distrito: La Experiencia De Rwanda
Introduction Contractual relationships are variously termed as "contractual approach", "contracting" and more recently, "performance-based financing" or "P4P" (payment for performance). The generic term "contracting" is too general to define this...
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Public-Private Partnerships for hospitals/Partenariats Public/prive En Faveur Des hopitaux/Alianzas Publicoprivadas Para Los Hospitales
Background The delivery of health care in almost every country involves some form of public-private partnership. In countries where care is delivered mainly through the public system, many inputs, such as pharmaceuticals and support services, are...
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Rousseau's "Social Contract": Contracting Ahead of Its Time?
Jean-Jacques Rousseau, born in Geneva in 1712, had an important influence on political philosophy in the 18th century and since, in particular through his book The social contract, published in 1762. (1,2) This monumental work is part of the family...
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The Benefits of Setting the Ground Rules and Regulating Contracting practices/Benefices De la Fixation De Regles De Base et De Pratiques Reglementees Pour la Passation De contrats/Beneficios Derivados del Establecimiento De Normas Fundamentales Y De la Regulacion De Las Practicas De Contratacion
Introduction In recent years, there has been considerable development of contracting almost everywhere in the health sector. Although a large body of experience on contracting has been documented, the results have often been promising but also occasionally...
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The Determinants of Policy Effectiveness
There is an old military saying: "Armchair generals talk strategy, professionals talk logistics". Much health sector policy reform is driven less by evidence than by armchair strategies shaped by ideology that frequently shows little regard for practical...
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Understanding Enrolment in Community Health Insurance in Sub-Saharan Africa: A Population-Based Case-Control Study in Rural Burkina Faso/Motifs De la Souscription D'une Assurance-Maladie Communautaire Par Les Habitants De l'Afrique Sub-Saharienne: Etude Cas-Temoin En Population Rurale Menee Au Burkina Faso/Analisis De la Decision De Acogerse a Un Seguro Medico Comunitario En El Africa
Introduction Community health insurance (CHI) is receiving increased attention as a means of health financing in low- and middle-income countries. In countries with limited ability to develop and sustain national health insurance programmes, CHI...
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