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Article ; Online: Service Delivery Transformation for UHC in Asia and the Pacific

Gerald Bloom

Health Systems & Reform, Vol 5, Iss 1, Pp 7-

2019 Volume 17

Abstract: This article was drafted as part of a review of strategies for making progress toward universal health coverage in the countries of Asia and the Pacific. It focuses on strengthening the delivery of services, in the context of population aging. It argues ... ...

Abstract	This article was drafted as part of a review of strategies for making progress toward universal health coverage in the countries of Asia and the Pacific. It focuses on strengthening the delivery of services, in the context of population aging. It argues that it is important to take into account big differences in development contexts and also the rapid, interconnected changes that many countries are experiencing. The article focuses especially on countries with relatively undeveloped institutions and pluralistic and highly segmented health sectors. It argues that attempts by these countries to import institutional arrangements from outside are likely to be complicated. It argues that government needs to focus on both short-term measures to meet immediate needs and the longer-term aim of establishing effective institutional arrangements. This means that they need to take into account the political factors that influence the direction of health system change. The article emphasizes the need to strengthen the capacity of the health system to address the growing challenge of chronic noncommunicable diseases to avoid heavy political pressure to expand hospital services. It then explores the opportunities and challenges associated with the rapid expansion of digital health services. It concludes with a discussion of government stewardship and management of health system transformation to address the major challenges associated with population aging.
Keywords	change management ; politics of health system change ; population aging ; primary health care ; universal health coverage ; Medicine (General) ; R5-920 ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Universal Health Coverage and Primary Healthcare

Gerald Bloom

International Journal of Health Policy and Management, Vol 6, Iss 4, Pp 229-

Lessons From Japan; Comment on “Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries”

2017 Volume 231

Abstract: A recent editorial by Naoki Ikegami has proposed three key lessons from Japan’s experience of achieving virtually universal coverage with primary healthcare services: the need to integrate the existing providers of primary healthcare services into the ... ...

Abstract	A recent editorial by Naoki Ikegami has proposed three key lessons from Japan’s experience of achieving virtually universal coverage with primary healthcare services: the need to integrate the existing providers of primary healthcare services into the organised health system; the need to limit government commitments to finance hospital services and the need to empower providers of primary healthcare to influence decisions that influence their livelihoods. Although the context of low- and middle-income countries (LMICs) differs in many ways from Japan in the late 19th and early 20th centuries, the lesson that short-term initiatives to achieve universal coverage need to be complemented by an understanding of the factors influencing long-term change management remains highly relevant.
Keywords	Universal Health Coverage (UHC) ; Primary Healthcare ; Politics of Health ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2017-04-01T00:00:00Z
Publisher	Kerman University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Understanding China’s growing involvement in global health and managing processes of change

Lewis Husain / Gerald Bloom

Globalization and Health, Vol 16, Iss 1, Pp 1-

2020 Volume 10

Abstract: Abstract Background Recent years have seen a rapid change in China’s global engagement and a recognition that solving global challenges will need to take the changing role of China into account. The paper discusses China’s growing involvement in global ... ...

Abstract	Abstract Background Recent years have seen a rapid change in China’s global engagement and a recognition that solving global challenges will need to take the changing role of China into account. The paper discusses China’s growing involvement in global health. Health is an area where there is broad agreement over global priorities and, potentially, a fertile space to build new forms of collaboration that point the way towards the adaptation of global governance to a rapidly changing context. Results Drawing on previous analyses of China’s management of change in its domestic health reforms and interviews with a range of stakeholders in China, the UK and Switzerland, the paper argues that China’s engagement in global health is developing and diversifying rapidly in response to the central government’s desire to see a greater role for China in global health. This diversification is part of a pattern of change management familiar from China’s domestic reform experience. Explorations underway by a range of Chinese agencies form part of a process of rapid experimentation and experiential learning that are informing China’s search for (a) new global role(s). Conclusions China is undergoing rapid institutional innovation and developing capacity for greater global engagement, including in health; however, substantial, recent leadership commitments make clear Chinese agencies’ need for continued exploration, innovation and rapid learning. How China engages globally is of significance to the world, not just China. The challenge for China, other global actors and multilateral organisations is to incorporate new approaches into existing global governance arrangements, including for the management of global health. This will require a willingness on all sides to learn from each other and invest the effort needed to build governance arrangements appropriate for the coming decades. This is not only important as a means of protecting global public health, but also as a demonstration of how governance arrangements can be adapted to the needs of a pluralistic global order in a context of rapid change.
Keywords	China ; Global health ; Global governance ; Complexity ; Change management ; Experimentation ; Public aspects of medicine ; RA1-1270
Subject code	950
Language	English
Publishing date	2020-05-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The China-UK Global Health Support Programme

Lewis Husain / Gerald Bloom / Sam McPherson

Global Health Research and Policy, Vol 5, Iss 1, Pp 1-

looking for new roles and partnerships in changing times

2020 Volume 8

Abstract: Abstract China’s engagement in global affairs has changed substantially in the 2010s. One aspect of the country’s global reorientation has been its increased interest in, and willingness to play a role in, global health. In the early 2010s, the UK ... ...

Abstract	Abstract China’s engagement in global affairs has changed substantially in the 2010s. One aspect of the country’s global reorientation has been its increased interest in, and willingness to play a role in, global health. In the early 2010s, the UK Department for International Development (DFID) initiated a collaboration with the Chinese government on a programme to support the country to play a greater and more effective global role in health and explore how the UK and China could work together on issues of key concern and contribute to improved global development outcomes. The programme worked with key Chinese agencies to carry out capacity building, support analysis of China’s approaches to engagement in global health governance and assistance, and provide support to government decision making. It also trialled several small-scale interventions in third countries through which Chinese agencies gained experience of working on health programmes overseas. The article reports on the main findings of an evaluation commissioned by DFID to learn from the programme. The programme provided support at a key time in China’s global reorientation; however, there is a need for continued development of capacity and systems for China to play the role envisaged by the country’s leadership. There is also a need for continued exploration on the part of China and partners of how to effectively collaborate to support improved global outcomes.
Keywords	Public aspects of medicine ; RA1-1270
Subject code	950
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Evaluation and learning in complex, rapidly changing health systems

Yue Xiao / Lewis Husain / Gerald Bloom

Globalization and Health, Vol 14, Iss 1, Pp 1-

China’s management of health sector reform

2018 Volume 11

Abstract: Abstract Healthcare systems are increasingly recognised as complex, in which a range of non-linear and emergent behaviours occur. China’s healthcare system is no exception. The hugeness of China, and the variation in conditions in different jurisdictions ...

Abstract	Abstract Healthcare systems are increasingly recognised as complex, in which a range of non-linear and emergent behaviours occur. China’s healthcare system is no exception. The hugeness of China, and the variation in conditions in different jurisdictions present very substantial challenges to reformers, and militate against adopting one-size-fits-all policy solutions. As a consequence, approaches to change management in China have frequently emphasised the importance of sub-national experimentation, innovation, and learning. Multiple mechanisms exist within the government structure to allow and encourage flexible implementation of policies, and tailoring of reforms to context. These limit the risk of large-scale policy failures and play a role in exploring new reform directions and potentially systemically-useful practices. They have helped in managing the huge transition that China has undergone from the 1970s onwards. China has historically made use of a number of mechanisms to encourage learning from innovative and emergent policy practices. Policy evaluation is increasingly becoming a tool used to probe emergent practices and inform iterative policy making/refining. This paper examines the case of a central policy research institute whose mandate includes evaluating reforms and providing feedback to the health ministry. Evaluation approaches being used are evolving as Chinese research agencies become increasingly professionalised, and in response to the increasing complexity of reforms. The paper argues that learning from widespread innovation and experimentation is challenging, but necessary for stewardship of large, and rapidly-changing systems.
Keywords	Healthcare system ; Change management ; Innovation ; Learning ; Policy evaluation ; China ; Public aspects of medicine ; RA1-1270
Subject code	950
Language	English
Publishing date	2018-11-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Health system innovations

Gerald Bloom / Annie Wilkinson / Abbas Bhuiya

Globalization and Health, Vol 14, Iss 1, Pp 1-

adapting to rapid change

2018 Volume 2

Abstract: Abstract This paper introduces the Thematic Issue on Innovation in Health Systems in Low- and Middle-Income Countries. ...

Abstract	Abstract This paper introduces the Thematic Issue on Innovation in Health Systems in Low- and Middle-Income Countries.
Keywords	Technological innovation ; Organizational innovation ; Change management ; Universal health coverage ; Low and middle-income countries ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2018-03-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: ICTs and the challenge of health system transition in low and middle-income countries

Gerald Bloom / Evangelia Berdou / Hilary Standing / Zhilei Guo / Alain Labrique

Globalization and Health, Vol 13, Iss 1, Pp 1-

2017 Volume 10

Abstract: Abstract The aim of this paper is to contribute to debates about how governments and other stakeholders can influence the application of ICTs to increase access to safe, effective and affordable treatment of common illnesses, especially by the poor. ... ...

Abstract	Abstract The aim of this paper is to contribute to debates about how governments and other stakeholders can influence the application of ICTs to increase access to safe, effective and affordable treatment of common illnesses, especially by the poor. First, it argues that the health sector is best conceptualized as a ‘knowledge economy’. This supports a broadened view of health service provision that includes formal and informal arrangements for the provision of medical advice and drugs. This is particularly important in countries with a pluralistic health system, with relatively underdeveloped institutional arrangements. It then argues that reframing the health sector as a knowledge economy allows us to circumvent the blind spots associated with donor-driven ICT-interventions and consider more broadly the forces that are driving e-health innovations. It draws on small case studies in Bangladesh and China to illustrate new types of organization and new kinds of relationship between organizations that are emerging. It argues that several factors have impeded the rapid diffusion of ICT innovations at scale including: the limited capacity of innovations to meet health service needs, the time it takes to build new kinds of partnership between public and private actors and participants in the health and communications sectors and the lack of a supportive regulatory environment. It emphasises the need to understand the political economy of the digital health knowledge economy and the new regulatory challenges likely to emerge. It concludes that governments will need to play a more active role to facilitate the diffusion of beneficial ICT innovations at scale and ensure that the overall pattern of health system development meets the needs of the population, including the poor.
Keywords	E-Health ; Digital health ; Health knowledge economy ; Universal health coverage ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2017-08-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Correction for global health and revenue effects of increased taxation of tobacco, Alcohol, and Sugar-Sweetened Beverages

Peter Aaby / Kristien Verdonck / Sameh Al-Awlaqi / Gerald Bloom / Por Ir / Kefilath Bello / Jean-Paul Dossou / Remco van de Pas / Wim Van Damme / Ritwik Dahake / Brecht Ingelbeen / Edwin Wouters / Guido Vanham / Stefaan Van der Borght / Devadasan Narayanan / Ian Van Engelgem / Mohamed Ali Ag Ahmed / Vincent De Brouwere / Helmut Kloos /

Andreas Kalk / Jean-Jacques Muyembe-Tamfum / Placide Mbala / Steve Ahuka-Mundeke / Yibeltal Assefa

BMJ Global Health, Vol 5, Iss

2020 Volume 7

Keywords	Medicine (General) ; R5-920 ; Infectious and parasitic diseases ; RC109-216
Language	English
Publishing date	2020-07-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The COVID-19 pandemic

Andreas Kalk / Jean-Jacques Muyembe-Tamfum / Placide Mbala / Steve Ahuka-Mundeke / Yibeltal Assefa

BMJ Global Health, Vol 5, Iss

diverse contexts; different epidemics—how and why?

2020 Volume 7

Abstract: It is very exceptional that a new disease becomes a true pandemic. Since its emergence in Wuhan, China, in late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, has spread to nearly all countries of the ... ...

Abstract	It is very exceptional that a new disease becomes a true pandemic. Since its emergence in Wuhan, China, in late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, has spread to nearly all countries of the world in only a few months. However, in different countries, the COVID-19 epidemic takes variable shapes and forms in how it affects communities. Until now, the insights gained on COVID-19 have been largely dominated by the COVID-19 epidemics and the lockdowns in China, Europe and the USA. But this variety of global trajectories is little described, analysed or understood. In only a few months, an enormous amount of scientific evidence on SARS-CoV-2 and COVID-19 has been uncovered (knowns). But important knowledge gaps remain (unknowns). Learning from the variety of ways the COVID-19 epidemic is unfolding across the globe can potentially contribute to solving the COVID-19 puzzle. This paper tries to make sense of this variability—by exploring the important role that context plays in these different COVID-19 epidemics; by comparing COVID-19 epidemics with other respiratory diseases, including other coronaviruses that circulate continuously; and by highlighting the critical unknowns and uncertainties that remain. These unknowns and uncertainties require a deeper understanding of the variable trajectories of COVID-19. Unravelling them will be important for discerning potential future scenarios, such as the first wave in virgin territories still untouched by COVID-19 and for future waves elsewhere.
Keywords	Medicine (General) ; R5-920 ; Infectious and parasitic diseases ; RC109-216 ; covid19
Language	English
Publishing date	2020-07-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Self-reported serious illnesses in rural Cambodia

Por Ir / Chean Men / Henry Lucas / Bruno Meessen / Kristof Decoster / Gerald Bloom / Wim Van Damme

PLoS ONE, Vol 5, Iss 6, p e

a cross-sectional survey.

2010 Volume 10930

Abstract: BACKGROUND: There is substantial evidence that ill-health is a major cause of impoverishment in developing countries. Major illnesses can have a serious economic impact on poor households through treatment costs and income loss. However, available ... ...

Abstract	BACKGROUND: There is substantial evidence that ill-health is a major cause of impoverishment in developing countries. Major illnesses can have a serious economic impact on poor households through treatment costs and income loss. However, available methods for measuring the impact of ill-health on household welfare display several shortcomings and new methods are thus needed. To understand the potential complex impact of major illnesses on household livelihoods, a study on poverty and illness was conducted in rural Cambodia, as part of an international comparative research project. A cross-sectional survey was performed to identify households affected by major illness for further in-depth interviews. METHODOLOGY AND PRINCIPAL FINDINGS: 5,975 households in three rural health districts were randomly selected through a two-stage cluster sampling and interviewed. 27% of the households reported at least one member with a serious illness in the year preceding the survey and 15% of the household members reported suffering from at least one serious illness. The most reported conditions include common tropical infectious diseases, chronic diseases (notably hypertension and heart diseases) and road traffic accidents. Such conditions were particularly concentrated among the poor, children under five, women, and the elderly. Poor women often reported complications related to pregnancy and delivery as serious illnesses. CONCLUSIONS AND SIGNIFICANCE: Despite some methodological limitations, this study provides new information on the frequency of self-reported serious illnesses among the rural Cambodia's population, which serves as a basis for further in-depth investigation on 'major illnesses' and their economic consequences on poor households. This can in turn help policy makers to formulate appropriate interventions to protect the poor from the financial burden associated with ill-health. Our findings suggest that every year a considerable proportion of rural population in Cambodia, especially the poor and vulnerable, are ...
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2010-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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