Bmc Public Health
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One of the challenges to maintain an agenda for universal coverage and equitable health system is to develop effective structuring and management of health financing. Global experiences with different systems of health financing suggests that a strong public role in health financing is essential for health systems to protect the poor and health systems with the strongest state role are likely the more equitable and achieve better aggregate health outcomes. Using Malaysia as a case study, this paper seeks to evaluate the progress and capacity of a middle income country in terms of health financing for universal coverage, and also to highlight some of the key underlying health systems challenges. ⋯ Service delivery-wise, there is a need to enhance financing capacity to expand preventive care, in better managing escalating healthcare costs associated with the increasing trend of non-communicable diseases. In tandem, health financing policies need to infuse the element of cost-effectiveness to better manage the purchasing of new medical supplies and equipment. Ultimately, good governance and leadership are needed to ensure adequate public spending on health and maintain the focus on the attainment of universal coverage, as well as making healthcare financing more accountable to the public, particularly in regards to inefficiencies and better utilisation of public funds and resources.
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Community food programs (CFPs), including soup kitchens and food banks, are a recent development in larger settlements in the Canadian Arctic. Our understanding of utilization of these programs is limited as food systems research has not studied the marginalised and transient populations using CFPs, constraining service planning for some of the most vulnerable community members. This paper reports on a baseline study conducted with users of CFPs in Iqaluit, Nunavut, to identify and characterize utilization and document their food security experience. ⋯ The inability of users to obtain sufficient food must be understood in the context of socio-economic transformations that have affected Inuit society over the last half century as former semi-nomadic hunting groups were resettled into permanent settlements. The resulting livelihood changes profoundly affected how food is produced, processed, distributed, and consumed, and the socio-cultural relationships surrounding such activities. Consequences have included the rising importance of material resources for food access, the weakening of social safety mechanisms through which more vulnerable community members would have traditionally been supported, and acculturative stress. Addressing these broader challenges is essential for food policy, yet CFPs also have an essential role in providing for those who would otherwise have limited food access.
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Universal coverage by health services is one of the core obligations that any legitimate government should fulfil vis-à-vis its citizens. However, universal coverage may not in itself ensure universal access to health care. ⋯ It also explores how 'gender-blind' organisation and delivery of health care services may deny universal access to women even when universal coverage has been nominally achieved. The paper then makes recommendations for addressing these.
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Thailand has achieved universal health coverage since 2002 through the implementation of the Universal Coverage Scheme (UCS) for 47 million of the population who were neither private sector employees nor government employees. A well performing UCS should achieve health equity goals in terms of health service use and distribution of government subsidy on health. With these goals in mind, this paper assesses the magnitude and trend of government health budget benefiting the poor as compared to the rich UCS members. ⋯ Higher utilization and better financial risk protection benefiting the poor UCS members are the results of extensive geographical coverage of health service infrastructure especially at district level, adequate finance and functioning primary healthcare, comprehensive benefit package and zero copayment at points of services.
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Many human infections are transmitted through contact with animals (zoonoses), including household pets. Although pet ownership is common in most countries and non-pet owners may have frequent contact with pets, there is limited knowledge of the public's pet contact practices and awareness of zoonotic disease risks from pets. The objective of this study was to characterize the general public's knowledge, attitudes and risks related to pet ownership and animal contact in southern Ontario, Canada. ⋯ These results suggest that there is a need for accessible zoonotic disease information for both pet and non-owning households, with additional efforts made by veterinary, human and public health personnel. Immediate educational efforts directed toward households with individuals at higher risk to infections are especially needed.