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The Healing of America A Global Quest for Better, Cheaper, and Fairer Health Care

Title of Article

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The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care

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Authors

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Jame Greco, Edward Thomson, Ernest Greco

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Source:

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Managing Research and Measurement of Work Related Stress. Global Review of World economics and business, 22: 141-192. New York, 2008.

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Aim of the study:

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The Fairer Health Care ultimate goal is better health for all people. World Health Organization (WHO) has identified five key elements to realizing and achieving this goal: for instance, reducing social disparities and exclusion in health (universal-coverage reforms); systematizing and organizing health care services around people’s expectations and needs (service delivery reforms); combining and integrating health into other different sectors (the public policy reforms);practicing and pursuing collaborative policy dialogue models (leadership reforms); and also increasing the participation of the stakeholders. Fairer Health Care is vital health care that is made accessible at a cost that a community or a country can afford, with processes and methods which are practical, socially acceptable and scientifically sound.

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Reasons for choosing this article:

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The article emphasizes that all people should have right to use Better, Cheaper, and Fairer Health Care services and also to access to PHC, and that everyone should take part in it. The approach of Fairer Health Care takes in the following major components: community participation, equity, intersectorality, technology appropriateness and affordable costs. As-a-set-of-activities, PHC should include at the very least the health education for all people and the entire community on the nature and size of health problems and also on methods of controlling and preventing these problems. Other important activities include the back-up or the promotion of adequate food supplies and right nutrition; basic hygiene and enough safe water; child and maternal health care, including immunization; family planning; appropriate treatment of injuries and common diseases; and the provision of some necessary drugs. As defined above, Fairer Health Care will do much in dealing with many of the pre-requisites for healthiness indicated earlier.

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Summary

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The articles demands accountable and concerned health worker practices. It prioritizes those people who are mostly disadvantaged by ensuring that the health care is equitable, accessible and affordable to all individuals. It recognizes the significance of provision of integrated services from the primary to tertiary levels of health care which are within a coherent or a consistent health system. Generally it promotes multi professional, inter-disciplinary and intersectoral collaborative joint effort development.

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Consequently at Alma-Ata earlier accepted strategies to medicine were metaphorically turned on their head. The curative medicine would later in the future take the 2nd place to prevention. All countries’ representatives that were in-attendance signed the Declaration of Alma-Ata and also pledged to go back home to begin channeling funds to PHC and to shift from the central control toward the regional control and the district control. These were radical changes that, if put into practice, would begin to encourage people to take-charge-of their health care. However such a spectacular shift in thoughts and action would need something that was not for all time forthcoming and accommodating political will. An evaluation that was conducted in the year 1983 confirmed that, even where there is political, those accountable for a nation’s mental, physical and social wellbeing did not have adequate spending power to make noteworthy improvements with no assistance. For that reason, in the year 1985 World Health Organization invited NGOs i.e. non-governmental organizations to help the governments to achieve the Alma-Ata goals. Several responded, mainly, by cooperating with the national governments in training the Fairer Health Care workers who were selected from their local communities.

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The critical evaluation of this article:

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A community development strategy has been adopted in the out-reach work component of the Alexandra Health Centre in South Africa. The significance of the local community organizations has been established and recognized and the Health Centre is not only seen as providing the technical answers/solutions but also as helping individuals to achieve improved and better conditions of living. This requires rigorous management, clear motivation and purposeful action by the health staff teams and also planning in-conjunction with the entire community.

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This outreach according to the article, system makes sure that the focus remains on the Alexandra residents and the community’s disadvantaged individuals such as the squatters, the disabled and the elderly. These services consist-of: community participation/involvement promotion, support of outreach services, community organizations, community education and health research on community services and outreach and information gathering for the health information system establishment.

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These outreach services according to the article, cover the neonatal and maternal health, workers’ health, child health, chronic and geriatric care and community-based education and rehabilitation. To meet all these requirements, a community based network of the health-extension staffs could be developed who are chosen, employed and trained by Alexandra Health Center. This training would cover PHC, resources of the community, education and communication techniques, and community based systems of information. The staffs would be based in the health units and each covering two thousand families, from-which several outreach services could be afforded and provided. Their duties would be environmental supervision, home visiting and community education and organization. The Alexandra Health Center also offers assistance with monetary management and also offers the physiotherapists and doctor services for the Nokuthula Center for Children who are Mentally Handicapped.

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This qualitative research aimed to explore PHC professionals’ outlooks on the community development and to discover the barriers and opportunities associated with the using of this approach/strategy in practice. Community development participants training—especially health visitors—took-part in some small group-discussions before and after and also 6 months following that training course. Opportunities for making use of a community development strategy/approach were identified however they were restricted by the lack of interest from a few communities, lack of support and leadership in health visiting and also by the increasing medicalization of the health promotion.

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There is a possible conflict between the community development ethos and the plan/aim of the national, policy driven public agenda. Proposals and recommendation are recommended to change the health visiting organization in order to aid in the adoption of the public health strategies/approaches including the community development. These amendments would enable the health visitors to use the help which is readily-available from the recently selected public-health practitioners, whose responsibility and role is to promote the public health practices in (PHC) Fairer Health Care.

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Public health is very high on the United Kingdom’s health care strategy agenda, and the nurses of the community are seen as been instrumental in helping in the reduction of health inequalities, in the promotion of social inclusion and in improving people’s circumstances and lifestyles. Government policies put emphasis on the partnerships between communities and agencies and working with individuals in the community to reduce the health inequalities and improve health.

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Many examples of all of these activities exist. Researches indicate that community support through the social networks is very protective of individual’s health (Shabecoff, 2001). High levels of density and trust of group membership are highly associated with the reduced mortality. On the other hand, lack of self esteem, lack of control and poor/ill social support greatly contribute to augmented morbidity. Needs appraisal that is mainly focused on the communities can identify the solutions as well as the problems.

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By continuing the existing neighborhood community development and also drawing together the voluntary groups and the initiatives of a local authority, an agency could challenge and support planning by the primary care group. Recommendations and information from the local people could directly go to the primary care group, at the same time this group could also ask representative lay outlooks or action on certain issues. This structure may possibly provide for some measure of responsibility and perhaps help the primary care group focus on the key social health determinants. It would facilitate the views of the users to be given proper respect and importance or weight in the process of planning.

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In conclusion, the authors state that broadening contribution in discussions of the Better, Cheaper, and Fairer Health Care strategy was a significant breakthrough. The signs of changes are building-up, global-in-scope, and extending across all sectors and levels. Many of all of these changes are linked directly to health, while some others have powerful possible effects on both health care and health. Fairer Health Care (PHC) needs to be adapted to changeable or varying circumstances at national and local levels. Any nation that establishes a firm basis for Fairer Health Care, provides for the needs and the necessities of its most needy and vulnerable populations and at one fell swoop, empowers its most deserted resource; women.

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