Tri-Service CHAMPUS Statistical Database Project (TCSDP): Outpatient Nonavailability Statement Procedures Health Services Command Catchment Areas Fiscal Year 1991

IntroductionCivilian–military relations play an important yet under-researched role in low-income and middle-income country epidemic response. One crucial component of civilian–military relations is defining the role of the military. This paper evaluates the role of Nigerian military during the 2014–2016 West African Ebola epidemic.MethodsFocus groups and key informant interviews were conducted throughout three states in North East region of Nigeria: Borno, Yobe and Adamawa. Participants were identified through mapping of stakeholder involvement in Nigerian epidemic response. English-translated transcripts of each key informant interview and focus group discussion were then coded and key themes were elucidated and analysed.ResultsMajor themes elucidated include developing inclusive coordination plans between civilian and military entities, facilitating human rights reporting mechanisms and distributing military resources more equitably across geographical catchment areas. The Nigerian Military served numerous functions: 37% (22/59) of respondents indicated ‘security/peace’ as the military’s primary function, while 42% (25/59) cited health services. Variations across geographic settings were also noted: 35% (7/20) of participants in Borno stated the military primarily provided transportation, while 73% (11/15) in Adamawa and 29% (7/24) in Yobe listed health services.ConclusionsRobust civilian–military relations require an appropriately defined role of the military and clear civilian–military communication. Important considerations to contextualise civilian–military relations include military cultural–linguistic understanding, human rights promotion, and community-based needs assessments; such foci can facilitate the military’s understanding of community norms and civilian cooperation with military aims. In turn, more robust civilian–military relations can promote overall epidemic response and reduce the global burden of disease.

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Public Expenditures for Mental Health Services in Canadian Provinces

The Canadian Journal of Psychiatry ◽

10.1177/0706743717741059 ◽

2017 ◽

Vol 63 (4) ◽

pp. 250-256 ◽

Cited By ~ 5

Author(s):

Jian Wang ◽

Philip Jacobs ◽

Arto Ohinmaa ◽

Anne Dezetter ◽

Alain Lesage

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Public Spending ◽

Health Spending ◽

Health Care Expenditures ◽

Fiscal Year ◽

Public Expenditures ◽

Hospital Inpatient ◽

Publicly Funded

Objective: The purpose of this study is to measure provincial spending for mental health services in fiscal year (FY) 2013 and to compare these cost estimates to those of FY 2003. Methods: This study estimated the costs of publicly funded provincial mental health services in FY 2013 and compared them to the estimates for FY 2003 from a previously published report. Our data were obtained from publicly accessible databases. The cross-year cost comparisons for provincial mental health services were restricted to general and psychiatric hospital inpatients, clinical payments to physicians and psychologists, and prescribed psychotropic medications. Total public expenditures were inflation adjusted and expressed per capita and as a percentage of the total provincial health spending. Results: Total public spending for mental health and addiction programs/services was estimated to be $6.75 billion for FY 2013. The largest component of the expenditures was hospital inpatient services ($4.02 billion, 59.6%), followed by clinical payments to physicians or psychologists ($1.69 billion, 25%), and then publicly funded prescribed psychotherapeutic medications ($1.04 billion, 15.4%). Nationally, the portion of total public spending on health that was spent on mental health decreased from FY 2003 to FY 2013 from 5.4% to 4.9%. Conclusion: Our results reveal that mental health spending, as a proportion of public health care expenditures, decreased in the decade from FY 2003 to FY 2013. Due to large differences in how the provinces report community mental health services, we still lack a comprehensive picture of the mental health system.

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Cost of provision of essential health Services in Public Health Centers of Jimma zone, Southwest Ethiopia; a provider perspective, the pointer for major area of public expenditure

Health Economics Review ◽

10.1186/s13561-021-00334-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Diriba Feyisa ◽

Kiddus Yitbarek ◽

Teferi Daba

Keyword(s):

Public Health ◽

Health Services ◽

Annual Cost ◽

Unit Cost ◽

Health Centers ◽

Fiscal Year ◽

Total Annual Cost ◽

Jimma Zone ◽

Cost Center ◽

Provider Perspective

Abstract Background Provision of up-to-date cost information is crucial for not only addressing knowledge gap on the cost of essential health services (EHS) but also budgeting, allocating adequate resources and improving institutional efficiency at public health centers where basic health services are delivered the most. Objective To analyze the costs of essential health services at public health centers in Jimma Zone. Methods A facility based cross-sectional study was conducted in public health centers of Jimma zone from April 10, 2018 to May 9, 2018. The study was conducted from a provider perspective using retrospective standard costing approach of one fiscal year time horizon. Step-down allocation was used to allocate costs to final services. All costs for provision EHS were taken into account and expressed in United States dollar (USD). Sixteen public health centers located in eight districts were randomly selected for the study. Results The Average annual cost of providing essential health services at health centers in Jimma zone was USD 109,806.03 ± 50,564.9. Most (83.7%) of the total Annual cost was spent on recurrent items. Nearly half (45%) of total annual cost was incurred by personnel followed by drugs and consumables that accounted around one third (29%) of the total Annual cost. Around two third (65.9%) of the total annual cost was incurred for provision of EHS at the final cost center. The average overall unit cost was USD 7.4 per EHS per year. Conclusion Cost providing an EHS at public health centers was low and so, necessitating funding of significant resources to provide standard health care. The variability in unit costs and cost components for EHS also suggest that the potential exists to be more efficient via better use of both human and material resources.

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Countryside may help ease India’s economic downturn

Emerald Expert Briefings ◽

10.1108/oxan-db253750 ◽

2020 ◽

Keyword(s):

Health Services ◽

Rural Areas ◽

Monsoon Rainfall ◽

Fiscal Year ◽

Economic Downturn ◽

Content Type ◽

Agricultural Growth ◽

Urban Firms

Significance Many urban firms are suffering labour shortages, as the nationwide lockdown forced millions of migrant labourers to leave the cities in which they were working and return to their homes in rural areas. Impacts GDP will likely contract heavily in fiscal year 2020/21 (April-March). Since ‘normal’ monsoon rainfall is forecast, there should be sizeable harvests this year, increasing the likelihood of agricultural growth. As COVID-19 cases continue to rise, health services in many cities could become overwhelmed.

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