HEALTH SYSTEMS MANAGEMENT AND FINANCIAL SUSTAINABILITY IN GEORGIA

The article discusses and evaluates Health systems management and financial sustainability in Georgian Health Institutions, also provides the analyses of the state of health care in the conditions of Georgia. Improving and further developing the primary health care system is crucial to controlling the financial sustainability and growth costs of the health care system, including increasing funding and access to funding, and strengthening the role of the planned outpatient sector - family physician, As well as effective management of patients with chronic diseases. Activating the role of the physician, thus enabling the early detection of various diseases, as well as the effective management of patients with chronic diseases. At the same time, we consider a significant increase in funding for medicines, which will reduce the aggravation of a number of diseases at the level of inpatient treatment, thus saving considerable financial resources in the universal program, which is spent in the inpatient sector, and also improves public health.

Clinical risk factors of ICU & fatal COVID-19 cases in Brazil

The Coronavirus disease 2019 (COVID-19) was first detected in China in December 2019. In a few months, the disease got pandemic proportions, overloading health systems all around the world. Risk factors related to the progression and outcome of the disease are still unclear. Moreover, clinical aspects of patients can differ between societies, and other demographic elements may impact survival responses. A better characterisation of local manifestation of COVID-19 is crucial to a better general understanding of the disease, and thus to improve treatment decisions and health systems’ management. In this article, we performed an initial analysis of clinical factors related to admission in ICU or death of SARS-CoV-2 confirmed Brazilian patients, based on 1,138,690 medical records from the Brazilian government. To our knowledge, this study is the first to assess clinical risk factors for disease progression in Brazil. We provide a concise data set of medical registers related to COVID-19 in the whole Brazilian territory, and we describe the baseline comorbidities and symptoms observed in the data collection. Then, we assess the correlation between the manifestation of symptoms/comorbidities and the patients’ survival response through Kaplan-Meier survival estimates. The results here reported are mostly in accordance with findings reported in previous works.

The importance of establishing supportive supervision feedback audit system in Gurage Zone health department

Supportive supervision is one of the most important tasks in health systems management. A baseline assessment conducted by the primary health care transformation initiative had shown that the Gurage Zone health department had been conducting regular supportive supervision every quarter for the last five years in Gurage Zone. The study proposed establishing a feedback auditing system as an intervention to routinely assess the progress of previous visit actions included in the written feedback. The finding showed the culture of working on previous supportive supervision action items by woreda (district) health offices were significantly improved.

HEALTH SECTOR DECENTRALIZATION AND ITS IMPLICATION TO HEALTH SERVICES IN INDONESIA

Background: After more than a decade, in what way decentralization has affected health service and population health status in Indonesia, is still partly known. This paper aims to review about to what extent the health sector decentralization has affected health services in Indonesia, especially in access and health systems management. Methods: We conducted systematic search studies using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We search for relevant studies using keywords ‘decentralization’ OR ‘decentralisation’ AND ‘(public health)’ AND ‘effect’ OR ‘impact’ AND ‘reform’ AND ‘(health inequalities)’ AND ‘Indonesia’ on electronic sources Proquest, Science Direct, and EBSCOHost. The articles then filtered using pre determined criterias and duplication removal. Results: Database search resulting on 628 articles in Proquest, 0 articles in Science Direct, and 13 articles in EBSCOHost. The screening result were 5 eligible articles. We found equality of access in health services were jeopardized by fragmented health services and worsen health disparities among districts that occured after decentralization. This worsen gap between the most developed provinces of Java-Bali and those of other island groupings affected the community’s health status. Low local government’s capacity in planning, managing and utilizing health resources were the most reported evidence in decentralized health system. Conclusion: This study concludes that good capacity of local government, coordination and monitoring system between central and local government, partnership with private sectors and community empowerment are essential to achieve better health outcome result in decentralized Indonesia. Keywords: Decentralization, Health Services, Health Policy, Indonesia

Developing primary health care in Thailand

Purpose The purpose of this paper is to describe progress in an across sectorial approach to primary health care at the district health service (DHS) level in Thailand in response to recent innovative national public policy directions which have been enshrined in constitutional doctrine and publicly endorsed by the Prime Minister. This paper describes one response to the Prime Minister’s challenge for Thailand to become the centre of learning in the sub-region in health management. Design/methodology/approach The authors utilised a descriptive case study approach utilising an analysis of the Naresuan University initiative of establishing the College of Health Systems Management (NUCHSM). Within that case study, there is a focus on challenges relevant to the socio-economic determinants of health (SOED) and an emphasis on utilising Sustainable Development Goals (SDGs) within the DHS structure. Findings The findings describe the establishment of the NUCHSM. A Master of Science (Health Systems Management) by research and a PhD degree have been created and supported by an international faculty. The Thailand International Cooperation Agency recognised NUCHSM by providing scholarships. International students are from Bangladesh, Bhutan, Kenya, Malawi and Timor Leste. Research consultancy projects include two in Lao People’s Democratic Republic; plus, a prototype DHS management system responsive to SDG attainment; and a project to establish a sustainable Ageing Society philosophy for a Thai municipality. Originality/value The case study on NUCHSM and its antecedents in its development have demonstrated originality in a long-standing international collaboration, and it has been recognised by the national government to provide scholarships to citizens of the countries in the sub-region to undertake postgraduate studies in health management. The concept of learning from each other and together, simultaneously as a group, through action research projects funded to enhance the evolution of DHSs is innovative.

A Gestão da Clínica em questão

*** Clinical Governance in question ***The discussion of Clinical Governance requires an approach that takes into account issues related to the power and role of different actors in production and management of the health. In this sense, it is sought a transformation of the practices of attention, management and of the own education so that they can produce an integral attention directed to the health needs of the people and populations. To do this, it is necessary to consider all those involved in this process and support the reading of reality through the criticality and the ability to dialogue different perspectives, including that of caregivers, health professionals and health systems management.