ECONOMIC EVALUATION FOR HEALTH ADVOCACY AND INFORMED POLICY

Background: Healthcare resources are limited therefore, adequate, appropriate and timely allocation of resources are important. Decision to invest on health care program can be made from the analysis of the information obtained on the cost and consequences of the various alternative health programs, often known as economic evaluation of health interventions.Aims: This write-up emphasizes on the importance of evidence driven policy of health intervention whereby economic evaluation should be performed to indicate whether investment on health intervention would benefit the country.Methods: Literature review on economic evaluation studies conducted by the first author during her 14 years tenure as academician had been performed. Various studies which applied the cost-effectiveness analysis tools to economically evaluate health interventions and programs in Malaysia and other countries are shared.Results: The economic evaluation studies cut across different programs such as disease prevention and treatment, public health monitoring and control, and implications of health issues to the healthcare system. Many of the findings have been used for advocacy to shape the delivery of more effective health intervention programs in the country.Conclusion: The country will benefit from economic evaluation studies which could provide evidence to assist in policy making on health programs for the country.Keywords: economic evaluation, health programs, policy making

“Do Their Own Thing”: Radical Health Care and the Fair Haven Community Health Center

Radical health reform movements of the 1960s inspired two widely adopted alternative health care models in the United States: free clinics and community health centers. These groundbreaking institutions attempted to realize bold ideals but faced financial, bureaucratic, and political obstacles. This article examines the history of Fair Haven Community Health Care (FHCHC) in New Haven, Connecticut, an organization that spanned both models and typified innovative aspects of each while resisting the forces that tempered many of its contemporaries’ progressive practices. Motivated by a tradition of independence and struggling to address medical neglect in their neighborhood, FHCHC leaders chose not to affiliate with the local academic hospital, a decision that led many disaffected community members to embrace the clinic. The FHCHC also prioritized grant funding over fee-for-service revenue, thus retaining freedom to implement creative programs. Furthermore, the center functioned in an egalitarian manner, enthusiastically employing nurse practitioners and whole-staff meetings, and was largely able to avoid the conflicts that strained other community-controlled organizations. The FHCHC proved unusual among free clinics and health centers and demonstrated strategies similar institutions might employ to overcome common challenges. (Am J Public Health. Published online ahead of print September 16, 2021: e1–e9. https://doi.org/10.2105/AJPH.2021.306417 )

1092Questioning health inequality as policy agenda in Korea: using Luke’s three-dimensional theory of power

Focus of Presentation Health inequality is an important public health concern in Korea. However, policies to reduce health inequalities still falls behind. This research focus on political agenda making process of health inequality. To achieve this aim, we utilized Lukes’ three-dimensional theory of power to explain current state of ‘health inequality’ as political agenda in South Korea. Findings We conducted 12 in-depth interviews with 6 policymakers and 6 practitioners, and focus-group interview with 5 researchers in 2016. From the qualitative analysis, we constructed 3 main themes. First theme, the perception, participants’ perspective on health inequality varied widely. Some participants assumed health inequality in Korea as an inevitable social condition, not even a problem to be tackled. Despite differing views on the condition, most participants attributed health inequality as result of accumulated result of socio-economic inequality. Second theme, the barriers, many claimed health inequality too abstract, complex, and ambiguous concept to be politicized. Policy actors saw current political apathy to paucity of empirical evidence, which was the complete opposite to the researchers. Third theme, the supression, was analyzed using luke's theory of power. On first dimension, the pluralistic power, conservative government has been marginalizing overal inequality issue. On second dimension, two major obstacles of growth-first policy and result-ased management of bureaucratic organization were found. On third dimension, the governmentality, 3 mechanisms that suppress health inequality were found. Those were medicalization of health, neoliberal discourse that individualize health as personal asset, and policy monopoly by 'health insurance' that absorbe every health-related issue. Conclusions/Implications In conclusion, we derived five propositions for making health inequality a policy agenda in Korea. Strong political leadership to tackle structrual inequality is needed, more decentralized, democratic governance system should be founded, intersectoral approach and comprehensive intervention for health inequality should be implemented, alternative health regime to reorganized current medicalization of health should suffuse, finally, more knowledge and experience to denaturalize health inequality should be followed. Key messages To tackle health inequality, power that supress health equity becoming policy agenda should be anlalized.

The Implications of Health Financing for Health Access and Equity in Nigeria

The Nigeria health system has performed woefully against all vital health indices, trailing behind many African countries despite its enormous potentials. The reason for this is mainly due to the financial risk Nigerians face in accessing health care. This study addresses the implications of the current health care financing in Nigeria on access and equity. It shows the imperativeness of an alternative health care financing in line with best practices, from comparable Low- and Middle-Income Countries (LMICs), apart from the current National Health Insurance Scheme (NHIS). The findings from this study recommend that the NHIS should be strengthened through the policy reform to embrace fund pooling/risk-sharing, subsidisation for the poor and the vulnerable, mandatory enrolment, and fragmentation of NHIS. Other considerations include increasing domestic fiscal space for health and utilising a tax-based financing mechanism that has been progressive in all LMICs, thereby preventing the need for unsustainable reliance on external funding. A comprehensive package of health at the point of care is also necessary. However, all these recommendations require the government to show a commitment to improve the country’s healthcare system through its health spending.

Mobile Application Get Nurse Sebagai Platform Digital Pelayanan Kesehatan Masa Pandemi Covid-19

In 2020, the whole world was hit by an epidemic of COVID-19 (coronavirus diseases-19). This creates new habits and changes the pattern of people's lives. Many people are worried that they will catch the virus if they go to places such as clinics or hospitals to get health services. The community has become more vigilant and is looking for safer alternative health services. Due to this concern, the authors created a digital platform for health services that can be accessed by the public easily and quickly. This study aims to create a digital platform to bridge people who need health services without having to leave the house with health workers, especially nurses. The Business Model Canvas (BMC) is used by the author as a system analysis method. System modeling uses the Unified Modeling Language (UML). To design the system, Kotlin is used as a programming language with an MVP (Model-View-Presenter) architecture and MySQL as a database. As well as the Usability Testing method used to test the system. The result of this research is the creation of a mobile platform that can easily help people whenever and wherever they need health services.

Reproductive Health: Need of the Hour

Reproductive health of women remains a major development task in any country. Reproductive health is a state of complete physical, mental and social well-being and not simply the absence of any disease, in all matters relating to the reproductive system and to its functions and processes. The Review Article outlines the current literature on women's reproductive health which consist abortion, sexually transmitted disease, child and forced marriage, contraceptive methods etc. current statistics related to women reproductive health also discussed in this paper. Reproductive health of women is maintained by reducing fertility rate and spacing among births. The use of various contraceptives is best known alternative. Health status of women has ramification and impact on the human well-being, economic growth and on their families also. Woman with poor health are likely to give birth to low weight infants and less care to their children. Moreover, Indian women have high mortality rates, particularly during childhood and in their reproductive years. Other problems in women in India are low level of education, son preference, pressure of dowry, lack of independence and decision making. All these factors also have impact on the health of women (Reproductive Health Strategy, 2010). In this review paper, the efforts are made to discuss reproductive health and related issues of Indian women. Review article concluded that reproductive system of females comprises of the ovaries, fallopian tubes, vagina uterus, mammary glands, breasts, and vulva. All of these female genital organs play significant roles in the production and transportation of gametes and also production of sex hormones. There are different life stages accompanying with sexual subsists and reproductive health issues that include fertility, contraception, menstruation, menopause, sexually transmissible infections and chronic health problems like PCOS or PCOD etc. Taking care of reproductive systems in the female body requires attention to one’s health and regular check-ups.

Effectiveness of “I Can Do It, You Can Do It” Health Promotion Program for Individuals With Disabilities

Date Presented 04/13/21 University of Kansas Medical Center OT supports many community programs to reduce health disparity in our community. The COVID-19 pandemic created a need for alternative health promotion programs. This study aimed to determine the feasibility of implementing the I Can Do It (ICDI) program virtually. Once established, a pre–post descriptive study was completed to explore ICDI further. The results may have strong influence on OT practice for adapting and executing interventions virtually. Primary Author and Speaker: Kayla Hamner

Assess the Knowledge and Attitude Regarding Alternative System of Medicine among the Adults in Rural Community Area

Introduction: The folk medicine which is available such as herb, flora, found and minerals. The people taking some treatment for improving health and treat the person which lies in ancient times. Some of the people of the alternative system such as homeopathy, Ayurveda, Siddha, Unani, naturopathy and yoga. The alternative system of medicine is widespread. This leads to improving knowledge regarding the alternative system of medicine in the rural community area. Background: The present study has been designed to capture the knowledge and attitude towards the Alternative health care system of medicine in its user and non-users to compare the differences in its source of knowledge among the rural community people. Knowledge regarding the alternative therapies that are living in the rural community area. The person has some knowledge regarding alternative health such as naturopathy, homeopathy, yoga, Unani and Siddha. The people will have known about alternative therapies. Objective: To assess the knowledge of adults in rural community areas regarding the alternative system of medicine. To assess the attitude towards an alternative system of medicine among rural community areas. Methods: The sample size is 100 among the adults in the rural community area. Results: In the present study 98% of the adults were having a positive attitude and only 2% of them had a negative attitude. Association of knowledge score and attitude score with the selected demographic variables there is a significant in the gender and not significantly associated with education, occupation, caste regarding the alternative system of medicine and significant association between attitude score the gender and not significantly associate with education, occupation, caste regarding the alternative system of medicine. Conclusion: This study revealed that in wardha city, there is relatively high public interest in complementary and alternative medicine and a significant number has a produce good awareness attitude toward complementary and alternative medicine.