Health Policy and Planning
Journal Data
| Type | JOURNAL |
|---|---|
| Publisher | Oxford University Press (GB) |
| ISSN | 0268-1080 / 1460-2237 |
| Scopus | 21308 |
| Wikidata | Q15758156 |
| OpenAlex | S155125020 |
| MAG | 155125020 |
| Website | https://academic.oup.com/heapol |
| Total publications | 3.093 |
| Coverage period | 1986 - 2026 |
| Country | GB |
| Language | EN |
| Access | Open Access |
| Indexing | DOAJ indexed • Scopus indexed |
| Cited by | 6.037 |
| Impact factor | 1.156 |
| SJR | 1.334 (Q1) |
| SNIP | 1.428 |
| CiteScore | 6.1 |
| h-index | 22 |
| i10-index | 144 |
| 2-year mean citedness | 0.0057 |
| Overton policy citations | 5 |
| Female authorship share | 51.1% |
This journal focuses on health policy and planning, which falls under broader social sciences like public health and policy studies. While medical anthropology exists, this venue's content is primarily policy-oriented rather than anthropological
Health Policy · Adolescent Sexual and Reproductive Health · Child and Adolescent Health · Child Nutrition and Water Access · Community Health and Development · Diverse Scientific and Economic Studies · Food Security and Health in Diverse Populations · Global Health and Surgery · Global Health Care Issues · Global Health Workforce Issues
Improving Medication Availability through Mobile Wallets and Pooled Community Funds
In Uganda, frequent shortages of antihypertensive medications hinder continuity of care, undermining blood pressure management. Building on preliminary ethnographic research, this study evaluates a community-led, mobile-wallet-based pooling intervention— MoPuleesa—designed to improve medication access at a rural clinic in Nakaseke District, Uganda. Over a seven-month period, 183 patients enrolled and were linked to a digital savings platform that…
Building Sustainable Public Health Data Science and Informatics Capacity
Prevention, detection, and response to pandemic-prone diseases involve collecting, analyzing, and applying data swiftly at scale. Achieving these goals requires adequate information technology and a skilled public health workforce capable of translating data into action. While public health informatics and data science programs are established in parts of the Western world, Eastern Europe and Central Asia (EECA) face significant gaps in education…
Managing Public-Private Partnerships for Health Diagnostics
This paper draws upon a process evaluation of a public-private partnership (PPP) for diagnostics in three Sub-Saharan African countries, Ethiopia, Ghana and Kenya. The study sought to identify challenges in managing health PPP projects and potential solutions. We used an extensive document review and 72 recent key informant interviews (KIIs), building on 63 KIIs previously conducted to analyze the African Health Diagnostics Platform (AHDP) projec…
WHO guidelines on physical activity, sedentary behaviour, and sleep for children under 5
WHO’s ‘24-hour movement guidelines’ provide integrated recommendations for physical activity, sedentary behaviour, and sleep to improve health outcomes in children aged 0–5. This study aimed to examine stakeholders’ perceptions about these guidelines to inform its future adoption, adaptation, and implementation decisions in Mongolia. Key stakeholders involved in young children's health and development were recruited through purposive sampling and…
Pain, policy, and the opioid dilemma in sub-Saharan Africa
Sub-Saharan Africa (SSA) faces a dual opioid dilemma: widespread undertreatment of moderate to severe pain due to limited access to essential opioid analgesics, alongside increasing concern about misuse and diversion in selected contexts. Opioids are clinically indicated for severe cancer-related pain, advanced chronic illness, major trauma, surgery, and end-of-life care, yet regional consumption remains disproportionately low relative to documen…
How to do (or not to do)… asset mapping in community health
Public health asset mapping involves working in a community partnership to form a systematic inventory of a local community’s health-promoting features. Assets include physical amenities such as parks or fitness centers, community clinics, welfare agencies, health-promoting non-governmental organizations, and businesses. A curated list of these resources constitutes an asset map that can be shared to promote better health and better health polici…
Stakeholder perceptions of political and economic factors influencing vaccination in two States with a high burden of zero-dose children in Nigeria
Globally, an estimated 22.7 million children are unimmunized or ‘zero-dose’ (ZD), with 3.1 million in Nigeria. The political and economic environment plays a critical role in influencing the number of ZD and under-immunized children. We explored stakeholder perceptions of the political and economic context of vaccination services in Kano and Lagos States, two Nigerian States with a high number of ZD children. We conducted stakeholder mapping, fol…
Untangling the complex web of alcohol policy needs and potential solutions in Brazil
Implementing evidence-based alcohol policies can reduce the negative impact of alcohol consumption on public health. However, Brazil has permissive alcohol policies and weakly adheres to World Health Organization’s recommendations as the ‘best buys’. To explore stakeholders’ perceptions of alcohol policy needs and barriers in Brazil, we conducted semi-structured interviews with 31 stakeholders, including 15 from civil society and 16 policymakers.…
Self-reported job histories
In the absence of documented health workforce deployment policies and limited access to key job history data, existing health systems research methods are inadequate for examining policy implementation. The analysis of self-reported job histories offers a valuable research method for overcoming these limitations; however, its application and usefulness remain largely unexamined in health system and policy research, particularly in the context of …
Multi-actor collaborations in primary health care implementation
Bottom-up theory demonstrates that networks of actors play important roles in policy implementation, yet limited attention has so far been paid to the influence that actor networks might have on the implementation of primary health care (PHC) strategies and outcomes. This study examined the roles actor networks play in the implementation of Community-based Health Planning and Services (CHPS) in Ghana, focusing on the nature and patterns of relati…
A narrative review on cost considerations in early intervention for deaf and/or hard-of-hearing children in Africa
Early intervention (EI) is essential for the language, social, and educational development of deaf and/or hard-of-hearing (DHH) children. In African countries, however, the implementation of EI remains significantly constrained by cost considerations and systemic service gaps. This narrative review synthesizes findings from 26 peer-reviewed publications to explore how cost influences access to and sustainability of EI services in Africa. Seven in…
State-church partnerships as an innovative strategy in healthcare delivery for universal health coverage in sub-Saharan Africa
Universal Health Coverage (UHC) remains a critical goal in sub-Saharan Africa (SSA), where healthcare systems face significant challenges. State-Church Partnership have emerged as an innovative strategy to address gaps in healthcare delivery, leveraging the extensive networks of Faith-Based Organizations to provide essential services, particularly in remote areas.This scoping review aimed to examine the existing models of State-Church Partnership…
Remittances, political economy and public health expenditure
This article revisits the argument that in the absence of good governance, remittance inflows cause the government to renege on the provision of social services and crowd out public finance where private substitutes exist. Using a quantile approach on a sample of African countries for the period 1990–2022, and after controlling for the endogeneity of remittances, the results show a positive contribution of remittances to public health expenditure…
Enrollment or dropout
Since children's participation in social health insurance (SHI) in China is voluntary, fluctuations in enrollment or dropout are inevitable. Using data from the two waves of the China Family Panel Study in 2020 and 2022, this study aims to examine these participation dynamics and their impact on children's health service utilization and medical expenses. Specifically, a balanced panel of 1958 children under the age of 15 was constructed, first-di…
Impact of integrated care models on inpatient costs and health services efficiency
Integrated care effectively addresses challenges like high costs and low efficiency in healthcare. This paper investigates the impact of integrated care models in urban China on inpatient costs and health services efficiency, and explores variations by age category, chronic disease status, and healthcare institution. Data is sourced from the insurance claims database in Guangzhou (2012–2015). Seven integrated care models are introduced at differe…
How much can healthier diets reduce future economic and human costs? Results from Ethiopia and the Philippines
As countries progress through the ‘nutrition transition’ and experience rising rates of obesity and noncommunicable disease, concern has broadened from a primary focus on economic consequences of child stunting, to incorporate multiple forms of malnutrition, including overweight and obesity, or a more ambitious set of individual dietary risk factors from the Global Burden of Disease work. This paper conceptualizes a methodology that uses unhealth…
Facilitators and barriers of public–private partnerships for universal health coverage in sub-Saharan Africa
Universal health coverage (UHC) provides a platform for attaining ‘Health for All’. Attaining UHC requires substantial investment and resources in the health sector. This can be challenging for many sub-Saharan African (SSA) countries. Public–private partnerships (PPPs) could be a potential solution. The implementation of healthcare PPPs for developing health system capacities for UHC presents both significant opportunities and notable challenges…
How effective are community health workers in managing and preventing perinatal depression in sub-Saharan Africa? A systematic review of quantitative evidence
The accessibility to the prevention and management of perinatal depression can be improved by using community health workers. This review was aimed at determining the effectiveness of interventions led by community health workers (CHWs) in reducing depressive symptoms and the prevalence of depression during the perinatal period. We conducted a search in PubMed, CINAHL, SCOPUS, and ProQuest Databases of Dissertation and Thesis (PQDT) to locate stu…
Celebrating the 40th anniversary of Health Policy and Planning
This year, 2026, we celebrate the 40th anniversary of this Journal, ‘Health Policy and Planning’. The journal was conceived in 1986 by Patrick Vaughan, Professor of Epidemiology at the London School of Hygiene and Tropical Medicine (LSHTM). We sadly marked his recent death in Issue 8 of 2025. He and Gill Walt, now Emeritus Professor of International Health Policy, were its founding editors; Anne Mills was co-editor in 1986/7 and 1993–2001 and rem…
Assessing the cost implications of integrating and scaling up HIV services for key populations in Kenya and Malawi
Limited research has been conducted on strategies to improve the efficiency of HIV services for key populations (KPs). This study investigates ways to enhance healthcare delivery efficiency, focusing on HIV services for KPs. We explore two strategies: expanding service volume and offering multiple HIV services within a single health facility. Using data from the Linkages Across the Continuum of HIV Services for Key Populations Affected by HIV (LI…
Assessing the costs of antenatal care in Eastern Ethiopia
Most sub-Saharan Africa (SSA) countries are implementing free maternity services starting from the first antenatal care (ANC) visit to postnatal care. However, out of pocket (OOP) health expenditures significantly affect the utilization of maternal services in SSA. Limited evidence exists on the costs incurred for ANC health service utilization in this region. This study aimed to assess the costs of ANC service utilization among adolescent and ad…
Time to fully account for cost in monitoring financial protection and universal health coverage in low- and middle-income settings
Financial protection is a core pillar of universal health coverage (UHC), yet current monitoring approaches in low- and middle-income countries (LMICs) largely focus on direct medical costs, neglecting direct transport costs and indirect time costs lost when seeking care. This commentary highlights the importance of fully accounting for these often-excluded costs, which disproportionately affect poorer and rural populations and can significantly …
Measuring and monitoring child health and well-being—an integral part of the climate change agenda
Climate change has far-reaching consequences for all aspects of human society (Romanello et al. 2023). Children are uniquely vulnerable to climate change for a multitude of physiological and developmental reasons as well as because of distinctive behaviors such as outdoor play that increase their exposure to climate-related stressors (EPA 2023). Several reviews have summarized the multiple direct and indirect pathways through which climate change…
Measuring and assessing corruption in public health systems in low- and middle-income countries
Corruption in health systems has serious implications for health outcomes and equitable care. Although various methods exist to measure it, their application, purpose, effectiveness, and context have not yet been systematically consolidated to enable learning. We conducted a scoping review to identify empirical approaches used to measure health-sector corruption globally, with a focus on low- and middle-income countries. We examined the opportuni…
Primary health care networks and impacts in low- and middle-income countries
Primary healthcare provider networks (PHCPNs) are increasingly recognized as promising strategies to effectively strengthen health systems in low- and middle-income countries (LMICs). However, there is limited information on the influence PHCPNs may have on the process and clinical outcomes of health services. This study sought to answer the questions: what is the extent, range, and nature of research on PHCPNs in LMICs, what are the types of PHC…
Constructing socio-economic status indices
Theoretically, measures of household wealth can be reflected by income, consumption or expenditure information. However, the collection of accurate income and consumption data requires extensive resources for household surveys. Given the increasingly routine application of principal components analysis (PCA) using asset data in creating socio-economic status (SES) indices, we review how PCA-based indices are constructed, how they can be used, and…
Reforming the health sector in developing countries
Policy analysis is an established discipline in the industrialized world, yet its application to developing countries has been limited. The health sector in particular appears to have been neglected. This is surprising because there is a well recognized crisis in health systems, and prescriptions abound of what health policy reforms countries should introduce. However, little attention has been paid to how countries should carry out reforms, much…
Doing' health policy analysis
The case for undertaking policy analysis has been made by a number of scholars and practitioners. However, there has been much less attention given to how to do policy analysis, what research designs, theories or methods best inform policy analysis. This paper begins by looking at the health policy environment, and some of the challenges to researching this highly complex phenomenon. It focuses on research in middle and low income countries, draw…
Overcoming barriers to health service access
Evidence suggests that demand-side barriers may be as important as supply factors in deterring patients from obtaining treatment. Yet relatively little attention is given, either by policy makers or researchers, to ways of minimizing their effect. These barriers are likely to be more important for the poor and other vulnerable groups, where the costs of access, lack of information and cultural barriers impede them from benefiting from public spen…
Community health workers and the response to HIV/Aids in South Africa
After a decline in enthusiasm for national community health worker (CHW) programmes in the 1980s, these have re-emerged globally, particularly in the context of HIV. This paper examines the case of South Africa, where there has been rapid growth of a range of lay workers (home-based carers, lay counsellors, DOT supporters etc.) principally in response to an expansion in budgets and programmes for HIV, most recently the rollout of antiretroviral t…
Has donor prioritization of HIV/Aids displaced aid for other health issues
Advocates for many developing-world health and population issues have expressed concern that the high level of donor attention to HIV/AIDS is displacing funding for their own concerns. Even organizations dedicated to HIV/AIDS prevention and treatment have raised this issue. However, the issue of donor displacement has not been evaluated empirically. This paper attempts to do so by considering donor funding for four historically prominent health a…
Health transition in middle-income countries
Concepts behind current health systems are no longer adequate for dealing with the growing complexity of the health arena, both internationally and nationally. It is now too simplistic to classify world health in bipolar terms, such as East versus West, or North versus South. Conversely, epidemiologic differentiation within each country is now producing internal polarization: diminishing health care budgets may increase competition for scarce res…
The emergence of global attention to health systems strengthening
After a period of proliferation of disease-specific initiatives, over the past decade and especially since 2005 many organizations involved in global health have come to direct attention and resources to the issue of health systems strengthening. We explore how and why such attention emerged. A qualitative methodology, process-tracing, was used to construct a case history and analyse the factors shaping and inhibiting global political attention f…
Understanding pathways for scaling up health services through the lens of complex adaptive systems
Despite increased prominence and funding of global health initiatives, efforts to scale up health services in developing countries are falling short of the expectations of the Millennium Development Goals. Arguing that the dominant assumptions for scaling up are inadequate, we propose that interpreting change in health systems through the lens of complex adaptive systems (CAS) provides better models of pathways for scaling up. Based on an underst…
Public social policy development and implementation
The public social policy and programme decisions that are made in low-income countries have critical effects on human social and development outcomes. Unfortunately, it would appear that inadequate attention is paid to analysing, understanding and factoring into attempts to reshape or change policy, the complex historical, social, cultural, economic, political, organizational and institutional context; actor interests, experiences, positions and …
Food sovereignty, food security and health equity
There has been growing policy interest in social justice issues related to both health and food. We sought to understand the state of knowledge on relationships between health equity-i.e. health inequalities that are socially produced-and food systems, where the concepts of 'food security' and 'food sovereignty' are prominent. We undertook exploratory scoping and mapping stages of a 'meta-narrative synthesis' on pathways from global food systems …
How to start thinking about investigating power in the organizational settings of policy implementation
Power, a concept at the heart of the health policy process, is surprisingly rarely explicitly considered in the health policy implementation literature for low and middle income countries. In an attempt to support empirical research on power, this paper outlines some of the key insights on power from implementation theory. It then describes examples of power that might be seen in health policy implementation settings, such as hospitals, clinics a…
The Lessons of User Fee Experience in Africa
This paper reviews the experience of implementing user fees in Africa. It describes the two main approaches to implementing user fees that have been applied in African countries, the standard and the Bamako Initiative models, and their common objectives. It summarizes the evidence concerning the impact of fees on equity, efficiency and system sustainability (as opposed to financial sustainability), and the key bottlenecks to their effective imple…
Mental health system costs, resources and constraints in South Africa
The inclusion of mental health in the Sustainable Development Goals represents a global commitment to include mental health among the highest health and development priorities for investment. Low- and middle-income countries (LMICs), such as South Africa, contemplating mental health system scale-up embedded into wider universal health coverage-related health system transformations, require detailed and locally derived estimates on existing mental…
How Do Researchers Influence Decision-Makers? Case Studies of Mexican Policies
Though the problems translating or applying research in policy-making are legion, solutions are rare. As developing countries increase their capacities to develop effective local solutions to their health problems, they confront the research/policy dilemma. Yet few descriptive studies of research-policy links can be found from developing countries, and the relevance of European and North American models and data is questionable. We report the res…
Does Antenatal Care Make a Difference to Safe Delivery? A Study in Urban Uttar Pradesh, India
Evidence to support that antenatal screenings and interventions are effective in reducing maternal mortality has been scanty and studies have presented contradictory findings. In addition, antenatal care utilization is poorly characterized in studies. As an exposure under investigation, antenatal care should be well defined. However, measures typically only account for the frequency and timing of visits and not for care content. We introduce a ne…
Improving the Quality of Private Sector Delivery of Public Health Services
Despite significant successes in controlling a number of communicable diseases in low and middle income countries, important challenges remain, one being that a large proportion of patients with conditions of public health significance, such as tuberculosis, malaria, or sexually transmitted diseases, seek care in the largely unregulated 'for profit' private sector. Private providers (PPs) often offer services which are perceived by users to be mo…
Which policy for caesarian sections in Brazil? An analysis of trends and consequences
This paper analyses the incidence of caesarian sections (C-sections) in Brazil. In the last decade, it has reached an extremely high level, higher than in any other country in the world. Socioeconomic and regional differences are established, using available national data on the caesarian section rate, which is higher in more prosperous regions and among wealthier women. The different factors influencing this high incidence, including sociocultur…
Lessons from community participation in health programmes
Although primary health care emphasizes community participation and many health care programmes attempt to develop participation, good analysis of these developments is still rare. This paper, based on a review of about 200 case studies, examines some of the lessons for planners which are emerging from experiences of the last decade. These lessons focus on the problems of defining the term ‘community participation’, of gaining and sustaining broa…
Barriers to healthcare coordination in market-based and decentralized public health systems
Although integrated healthcare networks (IHNs) are promoted in Latin America in response to health system fragmentation, few analyses on the coordination of care across levels in these networks have been conducted in the region. The aim is to analyse the existence of healthcare coordination across levels of care and the factors influencing it from the health personnel' perspective in healthcare networks of two countries with different health syst…
Insured yet vulnerable
Protecting households from high out-of-pocket (OOP) payments for health care is an important health system goal. High OOP payments can push households into poverty and make them vulnerable to catastrophic health expenditures. This study, based in India, aims to: (a) estimate OOP payments for health and related impoverishment across economic groups; (b) decompose OOP payments and relate the contribution of their components to impoverishment; and (…
Why so many caesarean sections? The need for a further policy change in Brazil
Caesarean sections in Brazil rose from 15 per cent of all births in 1970 to over 30 per cent in 1980. A new policy was introduced by the largest medical care provider (INAMPS) which made the reimbursement fee payable to doctors the same for both vaginal and caesarean section deliveries. However, the caesarean rate has continued to rise. This study analysed the antenatal care and deliveries of over 7000 births which occurred during 1982 in the cit…
Trends in hospitalizations for primary care sensitive conditions following the implementation of Family Health Teams in Belo Horizonte, Brazil
OBJECTIVES: How to provide effective and efficient care to the burgeoning and aging populations of the major cities of low- and middle-income countries constitutes one of the principle public health issues of our times. We evaluated the Family Health Strategy, the Brazilian national health system's public approach to primary health care, in the major city of Belo Horizonte, describing trends and factors associated with hospitalizations for primar…
Socio-economic and ethnic group inequities in antenatal care quality in the public and private sector in Brazil
BACKGROUND: Socio-economic inequalities in maternal and child health are ubiquitous, but limited information is available on how much the quality of care varies according to wealth or ethnicity in low- and middle-income countries. Also, little information exists on quality differences between public and private providers. METHODS: Quality of care for women giving birth in 2004 in Pelotas, Brazil, was assessed by measuring how many of 11 procedure…
Global health funding
Global health funding has increased in recent years. This has been accompanied by a proliferation in the number of global health actors and initiatives. This paper describes the state of global heath finance, taking into account government and private sources of finance, and raises and discusses a number of policy issues related to global health governance. A schematic describing the different actors and three global health finance functions is u…
Ten best books in … medical demography
Journal Article Ten best books in ... medical demography Get access William Brass William Brass Professor of Medical Demography London School of Hygiene and Tropical Medicine Search for other works by this author on: Oxford Academic PubMed Google Scholar Health Policy and Planning, Volume 1, Issue 3, September 1986, Pages 270–271, https://doi.org/10.1093/heapol/1.3.270 Published: 01 September 1986
Ten best books in … epidemiology
Journal Article Ten best books in ... epidemiology Get access Patrick Vaughan Patrick Vaughan Reader, health care epidemiology London School of Hygiene and Tropical Medicine Search for other works by this author on: Oxford Academic PubMed Google Scholar Health Policy and Planning, Volume 1, Issue 1, March 1986, Pages 77–78, https://doi.org/10.1093/heapol/1.1.77 Published: 01 March 1986
Ten best books in … health economics
Journal Article Ten best books in ... health economics Get access Anne Milts Anne Milts Lecturer in Financial Planning London School of Hygiene and Tropical Medicine and London School of Economics and Political Science Search for other works by this author on: Oxford Academic PubMed Google Scholar Health Policy and Planning, Volume 1, Issue 4, December 1986, Pages 360–361, https://doi.org/10.1093/heapol/1.4.360 Published: 01 December 1986
PC software review CDC Anthropometric Software Package (Casp)
PC software review CDC Anthropometric Software Package (CASP) Get access Cesar G Victora Cesar G Victora Associate Professor Department of Social Medicine Faculty of Medicine Universidade Federal de Pelotas C.P. 46496001 Pelotas, RS, Brazil Search for other works by this author on: Oxford Academic PubMed Google Scholar Health Policy and Planning, Volume 1, Issue 1, March 1986, Pages 84–85, https://doi.org/10.1093/heapol/1.1.84 Published: 01 March…
PC software review SPSS/PC+ for IBM PCs
Journal Article PC software review SPSS/PC+ for IBM PCs Get access Simon Cousens Simon Cousens Department of Tropical Hygiene/Tropical Epidemiology Unit London School of Hygiene and Tropical MedicineUK SPSS UK Ltd, London House, 243-253 Lower Mortlake Road, Richmond, Surrey TW9 2LL, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar Health Policy and Planning, Volume 1, Issue 3, September 1986, Pages 277–278, https…
PC software review WordStar 2000 Release 2
PC software review Lotus 1–2–3
Journal Article PC software review Lotus 1–2–3 Get access PH Corran PH Corran National Institute for Biological Standards and ControlLondon UK Search for other works by this author on: Oxford Academic PubMed Google Scholar Health Policy and Planning, Volume 1, Issue 2, June 1986, Pages 184–185, https://doi.org/10.1093/heapol/1.2.184 Published: 01 June 1986
The world economic crisis. Part 2
As outlined in the first part of this article in the last issue of the journal, many countries are facing severe constraints on health expenditure at the same time as they are trying to work towards Health for All by the Year 2000. Health manpower needs to be planned to secure maximum benefits from the limited resources available. Many medical schools train more doctors than are needed because quotas on medical places are either non-existent or s…
Ageing in developing countries
Ageing in developing countries: are we meeting the challenge? Get access Alexandre Kalache Alexandre Kalache Senior Research Fellow, Unit for Epidemiology of Ageing, Community Health Department, London School of Hygiene and Tropical MedicineUK Search for other works by this author on: Oxford Academic PubMed Google Scholar Health Policy and Planning, Volume 1, Issue 2, June 1986, Pages 171–173, https://doi.org/10.1093/heapol/1.2.171 Published: 01 …
The dynamics of health policies in Mozambique 1975–85
In 1985 Mozambique commemorated its tenth year of independence against a background of a continuing need to defend the country, not only against the actions of the externally-backed Mozambique National Resistance (MNR), but also against drought, acute food shortages and a world economic recession. These external factors have significant implications for the Implementation of Mozambique's health policy. The MNR has chosen as deliberate targets for…
Reducing the impact of natural disasters
Natural disasters can be classified into four main types: floods, earthquakes, cyclones and droughts. This paper compares these types of natural disaster in terms of four characteristics: predictability, scope, onset delay and lethality. Special attention is paid to the last of these characteristics. It is found that the mortality and morbidity associated with natural disasters has changed over time and varies between regions. The variation betwe…
An epidemiological approach to health planning and problem-solving in Indonesia
Daerah Istimewa Aceh, with a population of 2.9 million, is located in northern Sumatra and is one of 27 provinces in Indonesia. Since 1982 a USAID-funded project (CHIPPS) has supported an experiment in Aceh involving decentralized health planning and problem-solving. Instead of following the usual Indonesian practice of rigidly adhering to strict health programme guidelines sent from Jakarta, Acehnese health officials tried to use an epidemiologi…
Child health interventions in urban slums
During the early part of the twentieth century, there were dramatic falls in the mortality rates in many cities in the West. The reasons for this improvement are of considerable relevance today because the conditions which prevailed at that time in cities such as New York are comparable to those prevailing in many slums of the Third World today. Some early studies linked the improvements in health, as measured by mortality rates, to a better leve…
Occupational health risks in Mexico
Alejandro Córdova, Gustavo Leal, Carolina Martinez; Occupational health risks in Mexico: missing information, Health Policy and Planning, Volume 1, Issue 4
Dactors, private paractice and primary health care development
Gerald Bloom, Richard Laing; Dactors, private paractice and primary health care development, Health Policy and Planning, Volume 1, Issue 3, 1 September 198
Health planning in India 1951–84
Detailed analysis of public sector health policy in India is rare. This paper contributes to the development of a more informed view of how policy is developed and implemented by presenting material on the overall pattern of central and state government health sector expenditures since 1951. In addition to financial information, there is a discussion of the processes involved and the roles of Ministries of Health and the Planning Commission. Thre…
The world economic crisis. Part 1
The widespread economic crisis has resulted in a fall in living standards in the western hemisphere of over 9% (1981-83) and in Sub-Saharan Africa they have fallen to the level of 1970. Food production in the African countries most seriously affected by drought dropped by 15% between 1981 and 1983. Living standards also fell in some countries in Europe and in some of the poorest countries of Asia. The high cost of fuel, the heavy burden of intere…
Why so many caesarean sections? The need for a further policy change in Brazil
Caesarean sections in Brazil rose from 15 per cent of all births in 1970 to over 30 per cent in 1980. A new policy was introduced by the largest medical care provider (INAMPS) which made the reimbursement fee payable to doctors the same for both vaginal and caesarean section deliveries. However, the caesarean rate has continued to rise. This study analysed the antenatal care and deliveries of over 7000 births which occurred during 1982 in the cit…
Do patients understand their physicians? Prescription compliance in a rural area of the Dominican Republic
Compliance with medical advice is an important component of medical care, but compliance cannot take place unless patients understand and retain physicians' advice. This paper is one of the first studies of the understanding and retention of medical advice in rural areas of the Third World. Researchers observed 119 medical consultations in a rural primary care clinic and later interviewed the patients in their homes. There were very few recommend…
Health care as an instrument of Apartheid policy in South Africa
The paper focuses on five central features of health policy in South Africa. These are: (1) the differential expenditure on the health services for Whites, Coloureds, Indians and Africans; (2) the inequality between rural and urban African health services; (3) the structure and financing of rural health services for Africans; (4) the recent restructuring of the urban health services for Whites, Coloureds and Indians under the New Constitution; an…
Preventing diarrhoea
Oral rehydration therapy (ORT) has become the cornerstone of most programmes of diarrhoea control, and is highly effective in preventing death from dehydration caused by acute watery episodes of diarrhoea. The effectiveness of ORT in reducing mortality from chronic or dysenteric diarrhoeas is believed to be low and, in addition, ORT can be expected to have little or no impact on diarrhoea morbidity rates. In view of this, ORT should be complement…
Supplementary feeding in refugee populations
Supplementary feeding programmes (SFPs) have come to be very widely accepted as an appropriate nutrition intervention in refugee populations. Two perceived roles for such programmes can be identified: SFPs a method of targeting food during the emergency phase of a refugee disaster and SFPs as a long-term measure for the prevention of malnutrition and rehabilitation of moderately malnourished individals. Though the use of SFPs to target food in an…
Evaluating community health worker performance in India
In 1977 the Government of India launched a health care experiment in which volunteers were used to provide a basic health care service. Community health workers have also been used in many small, non-governmental programmes. Although much has been said about the selection and training of such workers, there have been very few attempts to evaluate their actual work performance. This paper makes the plea for more, regular evaluations of their activ…
Farm labour in Zimbabwe
Health indicators and factors affecting health status were surveyed in 4 areas of Mashonaland, Zimbabwe, in order to compare the health status of different occupational groups, in particular farm labourers, mineworkers and peri-urban workers. The surveys included nutritional anthropometry of the under 5s, data on demographic patterns and interviews to assess factors such as income, diet, environmental conditions and access to health services. It …
Priority for primary health care
National health policies of many countries stress priority for primary health care (PHC). This emphasis has arisen as a reaction to large expenditures on hospitals and sophisticated technology in major cities of developing countries, while vast rural populations have been virtually ignored. The paradox developed from colonial and neo-colonial emulation of European and North American medical models. In 1978, an international conference of WHO/UNIC…