Accounting for the cost of scaling-up health interventions

Recent studies such as the Commission on Macroeconomics and Health have highlighted the need for expanding the coverage of services for HIV/AIDS, malaria, tuberculosis, immunisations and other diseases. In order for policy makers to plan for these changes, they need to analyse the change in costs when interventions are 'scaled-up' to cover greater percentages of the population. Previous studies suggest that applying current unit costs to an entire population can misconstrue the true costs of an intervention. This study presents the methodology used in WHO-CHOICE's generalised cost effectiveness analysis, which includes non-linear cost functions for health centres, transportation and supervision costs, as well as the presence of fixed costs of establishing a health infrastructure. Results show changing marginal costs as predicted by economic theory.     

Tackling the scaling-up problem of digital health applications

Journal of Public Health - The purpose of this editorial is to provide guidance for the readers concerning the broad realm of approaches towards successful implementation of digital health...     

The main challenges

The last few decades have witnessed dramatic changes, not only in health, but also in all aspects of human life. From the social point of view, the individual and family are again becoming the focus of attention, and there is an increasing concern about socio-economic conditions and human rights. From the health point of view, morbidity and mortality patterns are changing and many people live longer and fewer people die. The reasons behind these changes are mainly the expansion in knowledge and technology and the concern about our lifestyles. These changes impact heavily on both medical education, the delivery of health services, and the cost of health care. Medical schools should respond by introducing changes in the medical education process and ensure the proper training of a new generation of doctors who are community- and socially oriented, capable of relating to the community and its needs. The health care system should also respond to these changes by restructuring its organization and finance to ensure quality in health care and that health services are not rationed according to an individual's ability to pay. There are apparent advantages in establishing close links between medical education and health care. Both systems and the community stand to gain from these links. Full integration of the two systems could be the final objective but should be preceded by careful study and experimentation.     

The physical challenges of early breastfeeding

Breastfeeding rates have recently increased in the United States and Canada and a majority of women now initiate breastfeeding. Feminist scholarship on breastfeeding has addressed a variety of issues related to women's breastfeeding experiences but has tended to ignore or downplay the potentially physically challenging aspects of early breastfeeding. This study, based on semi-structured, in-depth interviews with 52 women from Canada and the United States conducted at approximately one month postpartum, examines women's experiences of pain and discomfort associated with breastfeeding. The findings demonstrate that many women experienced pain and discomfort and that they were generally surprised by the extent, intensity and duration of discomfort and pain, which ranged from mild to severe. Several women indicated that the physical impact of breastfeeding affected their relationship with their baby; others indicated that they became hesitant to continue the practice due to feelings of physical vulnerability, pain and/or discomfort. Lastly, women's experiences of the physical implications of breastfeeding were influenced in part by assistance provided by health care practitioners, in both positive and negative ways. The practice of breastfeeding has the potential to challenge women's physicality. Feminist scholars addressing the topic of breastfeeding, women's postpartum health, and embodiment must more directly and comprehensively account for the potentially negative physical implications and demands associated with early breastfeeding.     

The challenges of developing new tuberculosis vaccines

The World Health Organization estimates that tuberculosis is causing nearly two million deaths annually, mostly in developing countries. Widespread administration of the current tuberculosis vaccine to newborns is not a reliable route for preventing the disease in adults, the population that drives the epidemic. Several new vaccine candidates are in development, and a few have entered clinical trials. However, the field faces formidable scientific and policy challenges. A collaborative approach to solving scientific, policy, and resource obstacles--as well as new partnerships among emerging economies and vaccine development organizations--will be critical to developing a new tuberculosis vaccine that could achieve its public health potential to save lives and reduce the burden of disease.     

The challenges of healthcare reforms in China

China is in the process of a new round of healthcare reforms. The Chinese Government has launched ambitious healthcare reforms aiming to achieve equitable access to basic health services; and to build a safe, effective, convenient and inexpensive healthcare system for both urban and rural residents. This paper will provide a brief overview of China's healthcare reforms, and describe the challenges and opportunities facing these reforms.     

平价医院面临的问题及发展思路

平价医院作为我国公立医院转变运行机制,回归平民医疗责任的一个过渡,引起了普通市民、社会各界专家和学者的极大关注,文章对平价医院目前所面临的主要问题进行分析,并对今后的发展思路进行了探讨。