Rifat Atun
Biographic Data
| ID | 381441 |
|---|---|
| NAME | Rifat Atun |
| GIVEN NAMES | Rifat |
| FAMILY NAME | Atun |
| SIGNATURE | ATUN R |
| AFFILIATIONS | Harvard University |
| ORCID | 0000-0002-1531-5983 |
| VERIFIED | Yes |
| TOTAL WORKS | 108 |
| TOTAL CITATIONS | 64 |
| AUTHOR COUNT | 108 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2006 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 5 |
Developing a scalable high-value solution for cancer care and control in India
Globally, health systems are underperforming in their cancer control response, and India is no exception [1]. India is experiencing accelerating cancer incidence and age-standardised mortality [2] with major disparities in relation to household income, geography, and gender [3]. Major gaps in cancer control and uneven distribution of facilities exacerbate challenges to care and outcomes [...]
Can role model women in politics help married women reduce suicides? Evidence from a quasi-experimental study in Brazil
Background: The medical literature has demonstrated that macro-variables and social factors can influence suicide rates. Additionally, social science literature has shown that women in prominent political positions (such as mayors) can influence the behavior of other women. The purpose of our work is to demonstrate that women in such positions reduce suicide rates within a group affected by gender inequality: married women. Methodology: We use re…
Optimising adolescents and young adults’ utilisation of sexual and reproductive health and HIV services in Chad
BACKGROUND: Adolescents and young adults (AYA) aged 15-24 years account for nearly half of all new HIV infections globally, with over 80% residing in sub-Saharan Africa, where AIDS is a leading cause of death. In Chad, HIV/AIDS significantly impacts AYA, despite a reduction in national prevalence from 1.6% in 2010 to 1.0% in 2022. AYA still contribute to 26.3% of new infections, with young women facing four times the risk compared with young men.…
Effective coverage for reproductive, maternal, neonatal and newborn health
BACKGROUND: Inadequate access to quality maternal and child health services leads to poor health outcomes for millions of women, particularly in low- and middle-income countries (LMICs). This study aims to explore the effective coverage of reproductive, maternal, neonatal and newborn health (RMNCH) services and examines socioeconomic and rural and urban disparities in 39 LMICs. METHODS: Using Demographic and Health Surveys (DHS) data, the researc…
The economic burden of ischaemic heart diseases on health systems
Using country-level variables to discover country clusters beyond traditional health policy and performance metrics
HIV remains a major public health challenge, with 1.4 million new infections and 31.6 million people accessing antiretroviral treatment in 2024. In many countries, HIV services have been provided through vertical programs, which, although highly successful in bringing treatment to people living with HIV since the early 2000s, are unlikely to sustain progress beyond donor dependency. The increasing push towards Universal Health Coverage (UHC), whi…
Global Adoption of Value-Based Health Care Initiatives Within Health Systems
This scoping review showed that since its formal introduction in 2006, VBHC has been widely recognized as a strategy for improving health system performance, but large-scale adoption will require a strategic shift toward integrating value-based components at national and regional levels. These findings highlight the need for research on effective implementation models, particularly in lower-resource settings, to guide policymakers and health syst…
Health systems strengthening through surgical and perioperative care pathways
Global health has traditionally focused on the primary health development with disease-specific focus such as HIV, malaria and non-communicable diseases (NCDs). As such, surgery has traditionally been neglected in global health as investment in them is often expensive, relative to these other priorities. Therefore, efforts to improve surgical care have remained on the periphery of initiatives in health system strengthening. However, today, many w…
Global maternal health country typologies
Maternal mortality remains a large challenge in global health. Learning from the experience of similar countries can help to accelerate progress. In this analysis we develop a typology of country groupings for maternal health and provide guidance on how policy implications vary by country typology. We used estimates from the Global Maternal Health (GMatH) microsimulation model, which was empirically calibrated to a range of fertility, process, an…
Multiple cardiovascular risk factor care in 55 low- and middle-income countries
The prevalence of multiple age-related cardiovascular disease (CVD) risk factors is high among individuals living in low- and middle-income countries. We described receipt of healthcare services for and management of hypertension and diabetes among individuals living with these conditions using individual-level data from 55 nationally representative population-based surveys (2009–2019) with measured blood pressure (BP) and diabetes biomarker. We …
The impact of health insurance on hypertension care
Health insurance did not show significant impact on improving hypertension care cascade among young and middle-aged adults with hypertension in India. Innovative strategies for overcoming practical barriers to healthcare services in addition to improving financial access are needed to address the large unmet need for hypertension care
The prevalence of cardiovascular disease risk factors among adults living in extreme poverty
Text mining analysis to understand the impact of online news on public health response
Background: To effectively combat the rising incidence of syphilis, the Brazilian Ministry of Health (MoH) created a National Rapid Response to Syphilis with actions aimed at bolstering epidemiological surveillance of acquired, congenital syphilis, and syphilis during pregnancy complemented with communication activities to raise population awareness and to increase uptake of testing that targeted mass media outlets from November 2018 to March 201…
Multimorbidity and out-of-pocket expenditure on medicine in Europe
Background Many European Health Systems are implementing or increasing levels of cost-sharing for medicine in response to the growing constrains on public spending on health despite their negative impact on population health due to delay in seeking care. Objective This study aims to examine the relationships between multimorbidity (two or more coexisting chronic diseases, CDs), complex multimorbidity (three or more CDs impacting at least three di…
Health service readiness to provide care for HIV and cardiovascular disease risk factors in low- and middle-income countries
Cardiovascular disease risk factors (CVDRF), in particular diabetes and hypertension, are chronic conditions which carry a substantial disease burden in Low- and Middle-Income Countries. Unlike HIV, they were neglected in the Millenium Development Goals along with the health services required to manage them. To inform the level of health service readiness that could be achieved with increased attention, we compared readiness for CVDRF with that f…
Quantifying the primary and secondary effects of antimicrobial resistance on surgery patients
Antimicrobial resistance (AMR) may negatively impact surgery patients through reducing the efficacy of treatment of surgical site infections, also known as the “primary effects” of AMR. Previous estimates of the burden of AMR have largely ignored the potential “secondary effects,” such as changes in surgical care pathways due to AMR, such as different infection prevention procedures or reduced access to surgical procedures altogether, with litera…
Multimorbidity and out-of-pocket expenditure for medicines in China and India
INTRODUCTION: Using nationally representative survey data from China and India, this study examined (1) the distribution and patterns of multimorbidity in relation to socioeconomic status and (2) association between multimorbidity and out-of-pocket expenditure (OOPE) for medicines by socioeconomic groups. METHODS: Secondary data analysis of adult population aged 45 years and older from WHO Study on Global Ageing and Adult Health (SAGE) India 2015…
Variation in the incidence of type 1 diabetes mellitus in children and adolescents by world region and country income group
Introduction Around 18.7 million of the 537 million people with diabetes worldwide live in low-income and middle-income countries (LMIC), where there is also an increase in the number of children, adolescents, and young adults diagnosed with type 1 diabetes (T1D). There are substantial gaps in data in the current understanding of the epidemiological patterns and trends in incidence rates of T1D at the global level. Methods We performed a scoping …
Patterns of multimorbidity in India
There is a dearth of evidence on the epidemiology of multimorbidity in low- and middle-income countries. This study aimed to determine the prevalence of multimorbidity in India and its variation among states and population groups. We analyzed data from a nationally representative household survey conducted in 2015–2016 among individuals aged 15 to 49 years. Multimorbidity was defined as having two or more conditions out of five common chronic mor…
How systems respond to policies
The coronavirus disease 2019 (COVID-19) pandemic has revealed the interdependency of health, economic and social systems (Rutter et al., 2020). The COVID-19 lockdown in Thailand and its unintended adverse outcomes illustrate this complexity, providing valuable lessons regarding the use of systems thinking to design successful policies. At the beginning of the pandemic, Thailand implemented a lockdown in its capital city, Bangkok. Ironically, the …
Sentiment Analysis in Understanding the Potential of Online News in the Public Health Crisis Response
This study analyzes online news disseminated throughout the pre-, during-, and post-intervention periods of the "Syphilis No!" Project, which was developed in Brazil between November 2018 and March 2019. We investigated the influence of sentiment aspects of news to explore their possible relationships with syphilis testing data in response to the syphilis epidemic in Brazil. A dictionary-based technique (VADER) was chosen to perform sentiment ana…
Which countries need Covid-19 vaccines the most? Development of a prioritisation tool
Several factors exist, extending beyond those currently used, which may lead to some countries having a greater need for vaccines compared to others. By assessing relative needs, this scoring tool can build on existing methods to further the role of equity in global COVID-19 vaccine allocation
Impact of extreme temperatures on emergency hospital admissions by age and socio-economic deprivation in England
Climate change poses an unprecedented challenge to population health and health systems' resilience, with increasing fluctuations in extreme temperatures through pressures on hospital capacity. While earlier studies have estimated morbidity attributable to hot or cold weather across cities, we provide the first large-scale, population-wide assessment of extreme temperatures on inequalities in excess emergency hospital admissions in England. We us…
Effect of socioeconomic inequalities and vulnerabilities on health-system preparedness and response to Covid-19 in Brazil
BACKGROUND: COVID-19 spread rapidly in Brazil despite the country's well established health and social protection systems. Understanding the relationships between health-system preparedness, responses to COVID-19, and the pattern of spread of the epidemic is particularly important in a country marked by wide inequalities in socioeconomic characteristics (eg, housing and employment status) and other health risks (age structure and burden of chroni…
Non-communicable disease risk factors and management among internal migrant in China
Integration of targeted health interventions into health systems
The benefits of integrating programmes that emphasize specific interventions into health systems to improve health outcomes have been widely debated. This debate has been driven by narrow binary considerations of integrated (horizontal) versus non-integrated (vertical) programmes, and characterized by polarization of views with protagonists for and against integration arguing the relative merits of each approach. The presence of both integrated a…
Health systems, communicable diseases and integration
The HIV/AIDS, tuberculosis and malaria pandemics pose substantial challenges globally and to health systems in the countries they affect. This demands an institutional approach that can integrate disease control programmes within health and social care systems. Whilst integration is intuitively appealing, evidence of its benefits remains uncertain and evaluation is beset by lack of a common understanding of what it involves. The aim of this paper…
Diffusion of complex health innovations--implementation of primary health care reforms in Bosnia and Herzegovina
Most transition countries in Central and Eastern Europe and Central Asia are engaged in health reform initiatives aimed at introducing primary health care (PHC) centred on family medicine to enhance performance of their health systems. But, in these countries the introduction of PHC reforms has been particularly challenging; while some have managed to introduce pilots, many have failed to these scale up. Using an innovation lens, we examine the i…
Brazil’s Family Health Strategy
Universal Health Coverage (UHC) is one of the United Nations Sustainable Development Goals (SDGs). Achieving UHC will require strong health systems to promote and deliver equitable and integrated healthcare services through primary healthcare (PHC). In Brazil, the Family Health Strategy (FHS) delivers PHC through the public health system. Created in 1994, the FHS covered almost 123 million individuals (63% of the Brazilian population) by 2015. Th…
Impact of extreme temperatures on emergency hospital admissions by age and socio-economic deprivation in England
Climate change poses an unprecedented challenge to population health and health systems' resilience, with increasing fluctuations in extreme temperatures through pressures on hospital capacity. While earlier studies have estimated morbidity attributable to hot or cold weather across cities, we provide the first large-scale, population-wide assessment of extreme temperatures on inequalities in excess emergency hospital admissions in England. We us…
The unfinished journey from Semashko to Bismarck
Following independence from the Soviet Union in 1991 and the subsequent rapid transition to a market economy, the Central Asian countries faced severe economic and social challenges. Between 1992 a
Global Fund investments in human resources for health
BACKGROUND: Since the early 2000s, there have been large increases in donor financing of human resources for health (HRH), yet few studies have examined their effects on health systems. OBJECTIVE: To determine the scope and impact of investments in HRH by the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), the largest investor in HRH outside national governments. METHODS: We used mixed research methodology to analyse budget all…
Health systems, systems thinking and innovation
Health systems play a critically important role in improving health. Well-functioning health systems enable achievement of good health with efficient use of available resources. Effective health systems also enable responsiveness to legitimate expectations of citizens and fairness of financing. By helping produce good health effectively, health systems also contribute to economic growth (McKee et al. 2009). Well-functioning health systems are cri…
An analysis of Gavi, the Global Fund and World Bank support for human resources for health in developing countries
Shortages, geographic imbalances and poor performance of health workers pose major challenges for improving health service delivery in developing countries. In response, multilateral agencies have increasingly recognized the need to invest in human resources for health (HRH) to assist countries in achieving their health system goals. In this paper we analyse the HRH-related activities of three agencies: the Global Alliance for Vaccines and Immuni…
Health systems strengthening
Significant scale-up of donors' investments in health systems strengthening (HSS), and the increased application of harmonization mechanisms for jointly channelling donor resources in countries, necessitate the development of a common framework for tracking donors' HSS expenditures. Such a framework would make it possible to comparatively analyse donors' contributions to strengthening specific aspects of countries' health systems in multi-donor-s…
A conceptual and analytical approach to comparative analysis of country case studies
Attempts to comparatively analyse large-scale communicable disease control programmes have, for the most part, neglected the wider health system contexts within which the programmes lie. In addition, many evaluations of the integration of vertical disease control programmes into health systems have focused on single case studies or on a limited number of cases, or, when large numbers of cases were drawn upon, have been presented as a compendium o…
Why do health systems matter? Exploring links between health systems and HIV response
INTRODUCTION: Studies on the relevance of stronger health systems to the success of vertical programmes has focused mainly on developing countries with fragile infrastructures and limited human resources. Research in middle-income, and particularly post-Soviet, settings has been scarce. This article examines the relationships between health system characteristics and the HIV response in Russia, the country which towards the end of the Soviet peri…
Stigma and HIV infection in Russia
Few studies have examined the personal and social consequences of stigma associated with HIV infection in Russia, a country with one of the most rapidly advancing HIV epidemics globally. By May 2005, Samara Oblast, Russia had 24,022 notified seropositive individuals. Focus-group discussions with randomly sampled seropositive and seronegative individuals, matched by age, gender and education were selected from the general population and used to pr…
Costs and outcomes of tuberculosis control in the Russian Federation
We analysed costs and outcomes of tuberculosis care for patients in a traditional Russian tuberculosis control system, using 3-year retrospective cohort data. Of 1749 cases at 3 years of follow-up, 65% were cured, 11.3% (198/1749) still had 'active' or 'chronic' disease, 10.3% had transferred out of the local civilian health care system and 12.7% had died. The mean cost of managing one case over 3 years was 886 US dollars: 1,078 US dollars for ba…
Diffusion of complex health innovations--implementation of primary health care reforms in Bosnia and Herzegovina
Most transition countries in Central and Eastern Europe and Central Asia are engaged in health reform initiatives aimed at introducing primary health care (PHC) centred on family medicine to enhance performance of their health systems. But, in these countries the introduction of PHC reforms has been particularly challenging; while some have managed to introduce pilots, many have failed to these scale up. Using an innovation lens, we examine the i…
The unfinished journey from Semashko to Bismarck
Following independence from the Soviet Union in 1991 and the subsequent rapid transition to a market economy, the Central Asian countries faced severe economic and social challenges. Between 1992 a
The Global Fund's leadership on harm reduction
How much will it cost? Estimation of resource needs and availability for HIV prevention, treatment and care for people who inject drugs in Asia
Health systems, communicable diseases and integration
The HIV/AIDS, tuberculosis and malaria pandemics pose substantial challenges globally and to health systems in the countries they affect. This demands an institutional approach that can integrate disease control programmes within health and social care systems. Whilst integration is intuitively appealing, evidence of its benefits remains uncertain and evaluation is beset by lack of a common understanding of what it involves. The aim of this paper…
A conceptual and analytical approach to comparative analysis of country case studies
Attempts to comparatively analyse large-scale communicable disease control programmes have, for the most part, neglected the wider health system contexts within which the programmes lie. In addition, many evaluations of the integration of vertical disease control programmes into health systems have focused on single case studies or on a limited number of cases, or, when large numbers of cases were drawn upon, have been presented as a compendium o…
Integration of targeted health interventions into health systems
The benefits of integrating programmes that emphasize specific interventions into health systems to improve health outcomes have been widely debated. This debate has been driven by narrow binary considerations of integrated (horizontal) versus non-integrated (vertical) programmes, and characterized by polarization of views with protagonists for and against integration arguing the relative merits of each approach. The presence of both integrated a…
Why do health systems matter? Exploring links between health systems and HIV response
INTRODUCTION: Studies on the relevance of stronger health systems to the success of vertical programmes has focused mainly on developing countries with fragile infrastructures and limited human resources. Research in middle-income, and particularly post-Soviet, settings has been scarce. This article examines the relationships between health system characteristics and the HIV response in Russia, the country which towards the end of the Soviet peri…
Interactions between critical health system functions and HIV/Aids, tuberculosis and malaria programmes
Towards an improved investment approach for an effective response to HIV/Aids
Does Russia need sex education? The views of stakeholders in three Russian regions
Objective To investigate the attitudes of the main stakeholders towards the introduction of sex education in schools in Russia. Design Qualitative semi-structured interview study. Setting Altai Krai, Volgograd Oblast, Moscow, Russian Federation. Participants One hundred and fifty-three interviews with Intersectoral HIV/AIDS Committee members, government officials responsible for HIV policies and interventions, non-governmental organisation and pr…
Sex, drugs and economic behaviour in Russia
Health systems strengthening
Significant scale-up of donors' investments in health systems strengthening (HSS), and the increased application of harmonization mechanisms for jointly channelling donor resources in countries, necessitate the development of a common framework for tracking donors' HSS expenditures. Such a framework would make it possible to comparatively analyse donors' contributions to strengthening specific aspects of countries' health systems in multi-donor-s…
Sexual and reproductive health activities in HIV programmes
BACKGROUND: Resource allocation and integration of services have been of interest recently to achieve health-related Millennium Development Goals. This paper analyses the extent to which countries receiving funding in HIV were able to invest in activities in the area of sexual and reproductive health (SRH). METHODS: The authors screened the Global Fund grants data with an aggregate investment of US$16 billion in 140 countries to identify indicato…
The effects of Global Fund financing on health governance in Brazil
OBJECTIVES: The impact of donors, such as national government (bi-lateral), private sector, and individual financial (philanthropic) contributions, on domestic health policies of developing nations has been the subject of scholarly discourse. Little is known, however, about the impact of global financial initiatives, such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria, on policies and health governance of countries receiving funding …
Global Fund investments in harm reduction from 2002 to 2009
This study represents the most comprehensive assessment of Global Fund investments in harm reduction. This funding, while substantial, falls short of the estimated needs. Investments in harm reduction must increase if HIV transmission among people who inject drugs is to be halved by 2015
Rethinking health systems strengthening
While reaching consensus on future plans to address current global health challenges is far from easy, there is broad agreement that reductionist approaches that suggest a limited set of targeted interventions to improve health around the world are inadequate. We argue that a comprehensive systems perspective should guide health practice, education, research and policy. We propose key 'systems thinking' tools and strategies that have the potentia…
Health systems, systems thinking and innovation
Health systems play a critically important role in improving health. Well-functioning health systems enable achievement of good health with efficient use of available resources. Effective health systems also enable responsiveness to legitimate expectations of citizens and fairness of financing. By helping produce good health effectively, health systems also contribute to economic growth (McKee et al. 2009). Well-functioning health systems are cri…
An analysis of Gavi, the Global Fund and World Bank support for human resources for health in developing countries
Shortages, geographic imbalances and poor performance of health workers pose major challenges for improving health service delivery in developing countries. In response, multilateral agencies have increasingly recognized the need to invest in human resources for health (HRH) to assist countries in achieving their health system goals. In this paper we analyse the HRH-related activities of three agencies: the Global Alliance for Vaccines and Immuni…
Universal health coverage in Turkey
Emergence of multilateral proto-institutions in global health and new approaches to governance
The role of multilateral donor agencies in global health is a new area of research, with limited research on how these agencies differ in terms of their governance arrangements, especially in relation to transparency, inclusiveness, accountability, and responsiveness to civil society. We argue that historical analysis of the origins of these agencies and their coalition formation processes can help to explain these differences. We propose an anal…
Global health initiative investments and health systems strengthening
BACKGROUND: Millions of dollars are invested annually under the umbrella of national health systems strengthening. Global health initiatives provide funding for low- and middle-income countries through disease-oriented programmes while maintaining that the interventions simultaneously strengthen systems. However, it is as yet unclear which, and to what extent, system-level interventions are being funded by these initiatives, nor is it clear how m…
Offline eLearning for undergraduates in health professions
Medicine (82 works) · Environmental health (51 works) · Health care (49 works) · Economic growth (48 works) · Political science (45 works) · Economics (40 works) · Population (39 works) · Business (36 works) · Healthcare Systems and Reforms (33 works) · Nursing (32 works)