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Samant M, Calnan M, Kane S. A critical analysis of newspaper accounts of violence against doctors in India. Soc Sci Med 2024; 340:116497. [PMID: 38096598 DOI: 10.1016/j.socscimed.2023.116497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/19/2023] [Accepted: 12/04/2023] [Indexed: 01/23/2024]
Abstract
This paper presents a critical analysis of newspaper articles (N = 60) published in a leading vernacular newspaper about violence against doctors in India. Adopting a theoretical perspective that considers 'news as a cultural practice,' a qualitative content analysis was conducted to examine how the phenomenon is framed and presented in the news, i.e., what is problematized, what causal links are drawn or hinted at, what moral stance is taken or alluded to, and what solutions are proffered and why, to arrive at a nuanced understanding of various aspects of this social phenomenon. Three overlapping key themes emerged from the analysis, namely the narrative of victimization, the changing doctor-patient relationship, and the crisis facing the 'noble profession' of medicine. It reveals how the media shapes public opinion and attitudes towards the state of the medical profession while in turn, reflecting existing opinions, attitudes, and cultural values; the analysis also reveals missing perspectives such as the voices of the patients and the public. We highlight how the findings are not merely the dominant ways in which the rise in incidents of violence against doctors is reported and is understood in society, but how media might have shaped the popular discourse around the issue and why. We reflect on what the reportage says about the state of the medical profession and its standing in society in India.
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Affiliation(s)
- Mayuri Samant
- Centre for Health Policy and Systems, Gokhale Institute of Politics and Economics, BMCC Road, Pune, India.
| | - Michael Calnan
- Room E134, Cornwallis East, School of Social Policy, Sociology, and Social Research, Canterbury, CT2 7NF, United Kingdom.
| | - Sumit Kane
- Centre for Health Policy and Systems, Gokhale Institute of Politics and Economics, BMCC Road, Pune, India; Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Pune, India.
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Zaman SB, Evans RG, Chow CK, Joshi R, Thankappan KR, Oldenburg B, Mahal AS, Kalyanram K, Kartik K, Riddell MA, Suresh O, Thomas N, Mini GK, Maulik PK, Srikanth VK, Thrift AG. Morbidity and utilisation of healthcare services among people with cardiometabolic disease in three diverse regions of rural India. Chronic Illn 2023; 19:873-888. [PMID: 36744377 PMCID: PMC10655594 DOI: 10.1177/17423953231153550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 01/11/2023] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To assess the prevalence and determinants of cardiometabolic disease (CMD), and the factors associated with healthcare utilisation, among people with CMD. METHODS Using a cross-sectional design, 11,657 participants were recruited from randomly selected villages in 3 regions located in Kerala and Andhra Pradesh from 2014 to 2016. Multivariable logistic regression was used to identify factors independently associated with CMD and healthcare utilisation (public or private). RESULTS Thirty-four per cent (n = 3629) of participants reported having ≥1 CMD, including hypertension (21.6%), diabetes (11.6%), heart disease (5.0%) or chronic kidney disease (CKD) (1.6%). The prevalence of CMD was progressively greater in regions of greater socio-economic position (SEP), ranging from 19.1% to 40.9%. Among those with CMD 41% had sought any medical advice in the last month, with only 19% utilising public health facilities. Among people with CMD, those with health insurance utilised more healthcare (age-gender adjusted odds ratio (AOR) (95% confidence interval (CI)): 1.31 (1.13, 1.51)) as did those who reported accessing private rather than public health services (1.43 (1.23, 1.66)). DISCUSSION The prevalence of CMD is high in these regions of rural India and is positively associated with indices of SEP. The utilisation of outpatient health services, particularly public services, among those with CMD is low.
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Affiliation(s)
- Sojib Bin Zaman
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Roger G Evans
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Australia
- Pre-clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Clara K Chow
- George Institute for Global Health, University of New South Wales, Sydney, Australia
- Department of Cardiology, Westmead Hospital, Sydney, Australia
| | - Rohina Joshi
- George Institute for Global Health, University of New South Wales, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
- George Institute for Global Health, New Delhi, India
| | | | - Brian Oldenburg
- Non-Communicable Diseases and Implementation Science, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Ajay S Mahal
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | | | | | - Michaela A Riddell
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Oduru Suresh
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
- Rishi Valley Rural Health Centre, Chittoor District, India
| | - Nihal Thomas
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India
| | - Gomathyamma K Mini
- Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Trivandrum, India
| | - Pallab K Maulik
- George Institute for Global Health, University of New South Wales, Sydney, Australia
- George Institute for Global Health, New Delhi, India
| | - Velandai K Srikanth
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Australia
| | - Amanda G Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
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Xia C, Xu J, Ding X. Alienation from medical care policy, medical care avoidance, and the role of sex and risk perception. BMC Psychiatry 2023; 23:594. [PMID: 37582725 PMCID: PMC10428645 DOI: 10.1186/s12888-023-05104-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 08/10/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Medical care avoidance affects individuals' health status. Previous studies on medical care avoidance have mainly focused on medical costs and people's satisfaction with medical services. This study investigates whether an individual's sense of policy alienation toward medical care policy (SPA-M) affects behavioral intention of medical care avoidance, and to what extent an intermediary variable-medical financial risk perception-mediates the relationship between SPA-M and medical care avoidance. METHODS A cross-sectional survey was conducted involving 434 people aged 35-59 years from Wuhu, a city in China's Anhui province. A moderated mediation model was constructed to investigate the research question and sex (biological: male and female) was used as a moderating variable between SPA-M and medical financial risk perception. RESULTS We found that SPA-M significantly impacted medical care avoidance, and that medical financial risk perception played a complete mediating role in this relationship, while sex moderated the relationship between SPA-M and medical financial risk perception. CONCLUSION This study contributes to the literature by enhancing our understanding of the factors that influence behavioral intention regarding medical care avoidance, deepening our understanding of the role of SPA-M in medical care policy, and expanding the role of sex differences in the analysis of the relationship between SPA-M, medical financial risk perception, and medical care avoidance, offering implications for public and community health.
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Affiliation(s)
- Chun Xia
- School of Educational Science, Anhui Normal University, Jiuhua-Nan-Road 189, Wuhu, Anhui Province, 241000, China
| | - Jia Xu
- School of Marxism, Anhui Normal University, Jiuhua-Nan-Road 189, Wuhu, Anhui Province, 241000, China.
| | - Xiuzhen Ding
- School of History, Anhui Normal University, Jiuhua-Nan-Road 189, Wuhu, Anhui Province , 241000, China
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Mathew M, Klabbers G, de Wert G, Krumeich A. Towards understanding accountability for physicians practice in India. Asian J Psychiatr 2023; 82:103505. [PMID: 36791611 DOI: 10.1016/j.ajp.2023.103505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/24/2023] [Accepted: 02/04/2023] [Indexed: 02/12/2023]
Abstract
The lack of accountability is considered to be a major cause of the crisis in health care in India. Physicians as key stakeholders in the health care delivery system have traditionally been accountable for health concerns at the doctor-patient interface. Following social and organizational dynamics, the interpretations of accountability have broadened and shifted in the recent literature, expanding accountability to the community, national and global levels and to social domains. The objective of this study is to provide a comprehensive framework of accountability in medical practice that can be used as a vehicle for further contextualized research and policy input. Through literature review, this paper is presented in two parts. First, a description of accountability of a physician inclusive of the social domains is extracted by posing three pertinent questions: who is accountable? accountability to whom? and accountability for what? which addresses the roles, relationships with other stakeholders and domains of accountability. Second, a framework of accountability of a physician is designed and presented to illustrate the professional and social domains. This study revealed a shift from individual physician's accountability to collective accountability involving multiple stakeholders through complex reciprocal and multi-layered mechanisms inclusive of the social dimensions. We propose a comprehensive framework of accountability of the physician to include the social domains that its multidimensional and integrative of all stakeholders. Furthermore, we discuss the utility of the framework in the Indian health care system and how this can facilitate further research in understanding the social dimensions of all stakeholders.
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Affiliation(s)
- Mary Mathew
- Department of Pathology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
| | - Gonnie Klabbers
- Faculty of Health, Medicine and Life Sciences, Department of Health Ethics and Society, Maastricht University, Maastricht, the Netherlands.
| | - Guido de Wert
- Maastricht University, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences; Department of Health Ethics and Society, Maastricht, the Netherlands.
| | - Anja Krumeich
- Maastricht University, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences; Department of Health Ethics and Society, Maastricht, the Netherlands.
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Thiagesan R, Gopichandran V, Soundari H. Ethical Framework to Address Barriers to Healthcare for People with Disabilities in India. Asian Bioeth Rev 2023; 15:1-11. [PMID: 36694541 PMCID: PMC9853476 DOI: 10.1007/s41649-023-00239-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 01/22/2023] Open
Abstract
Disability is one of the key public health issues in India and the burden will increase given the trend of an aging population. People with disabilities experience greater vulnerability as they may develop secondary health issues. They face various barriers while accessing health services. This is a major ethical concern. In this article, we frame the barriers to healthcare provision to persons with disabilities and propose an ethical framework to address these barriers. This ethical framework is derived from the basic ethical principles of justice, fairness, trust, solidarity, stewardship, proportionality, and responsiveness. The framework proposes strategies to address these barriers to healthcare service delivery for persons with disabilities in India.
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Affiliation(s)
- Rajeswaran Thiagesan
- Centre for Applied Research, The Gandhigram Rural Institute – Deemed to be University, Dindigul, Tamil Nadu India
- Resource Group for Education and Advocacy for Community Health (REACH), Chennai, India
| | - Vijayaprasad Gopichandran
- Department of Community Medicine, ESIC Medical College & Post Graduate Institute of Medical Science and Research (PGIMSR), Chennai, India
| | - Hilaria Soundari
- Centre for Applied Research, The Gandhigram Rural Institute – Deemed to be University, Dindigul, Tamil Nadu India
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Public Trust in Dentists among Arabic Populations. Int J Dent 2023; 2023:8359780. [PMID: 36874982 PMCID: PMC9984256 DOI: 10.1155/2023/8359780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 02/03/2023] [Accepted: 02/15/2023] [Indexed: 03/07/2023] Open
Abstract
Objective To investigate public trust in dentists, fear of dentists, factors related to trust, and the impact of the COVID-19 pandemic on the trust in dentists. Materials and Methods We used an Arabic online anonymous survey to collect data from a random population of 838 adults to investigate public trust in dentists, the factors they perceive to affect trust, their perception of key factors in the dentist-patient relationship, fear of dentists, and the impact of the COVID-19 pandemic on the level of their trust in the dentists. Results Eight hundred thirty-eight subjects with a mean age of 28.5 responded to the survey (595 (71%) females, 235 (28%) males, and 8 (1%) did not specify their gender). More than half trust their dentist. The COVID-19 pandemic did not decrease trust in dentists according to 62.2%. There were significant gender differences in reporting fear of dentists (p < 0.001) and in the perception of factors affecting trust (p=0.028). Honesty was chosen by 583 (69.6%), competence by 549 (65.5), and dentist's reputation by 443 (52.9%). Conclusions The findings of this study show that the majority of the public trust dentists, more females reported fear of dentists, and the majority perceived honesty, competence, and reputation as key factors affecting trust in the dentist-patient relationship. The majority reported that the COVID-19 pandemic did not have a negative impact on their trust in dentists.
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Zuhair M, Roy RB. Eliciting relative preferences for the attributes of health insurance schemes among rural consumers in India. INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2022; 22:443-458. [PMID: 35394574 DOI: 10.1007/s10754-022-09327-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 03/12/2022] [Indexed: 06/14/2023]
Abstract
There is a limited understanding of the preferences of rural consumers in India for health insurance schemes. In this article, we investigate the preferences of the rural population for the attributes of a health insurance scheme by implementing a discrete choice experiment (DCE). We identified six attributes through qualitative and quantitative study: enrollment, management, benefit package, coverage, transportation facility, and monthly premium. A D-efficient design of 18 choices has been constructed, each comprising two health insurance choices. We collected the representative sample from 675 household heads of the rural population through personal interviews. The preferences for the attributes and attribute levels were estimated using the multinomial logit (MNL) and random-parameter logit (RPL) models. The analysis shows that all attribute levels significantly affect the choice behavior (P < 0.05). The relative order of preferences for attributes are; enrollment, benefit package, monthly premium, management, coverage, and transportation.
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Affiliation(s)
- Mohd Zuhair
- Department of Computer Science and Engineering, Institute of Technology, Nirma University, Ahmedabad, Gujarat, India.
| | - Ram Babu Roy
- Indian Institute of Technology Kharagpur, Kharagpur, West Bengal, India
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Keshri VR, Sriram V, Baru R. Reforming the regulation of medical education, professionals and practice in India. BMJ Glob Health 2021; 5:bmjgh-2020-002765. [PMID: 32868269 PMCID: PMC7462148 DOI: 10.1136/bmjgh-2020-002765] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/13/2020] [Accepted: 07/28/2020] [Indexed: 12/16/2022] Open
Affiliation(s)
- Vikash Ranjan Keshri
- Injury Division, The George Institute for Global Health India, New Delhi, India .,Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Veena Sriram
- Center for Health and the Social Sciences, University of Chicago, Chicago, Illinois, USA
| | - Rama Baru
- Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India
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Iyer V, Mavalankar D, Tolhurst R, De Costa A. Perceptions of quality of care during birth at private Chiranjeevi facilities in Gujarat: lessons for Universal Health Coverage. Sex Reprod Health Matters 2020; 28:1850199. [PMID: 33336626 PMCID: PMC7887934 DOI: 10.1080/26410397.2020.1850199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The Indian national health policy encourages partnerships with private providers as a means to achieve universal health coverage. One of these was the Chiranjeevi Yojana (CY), a partnership since 2006 with private obstetricians to increase access to institutional births in the state of Gujarat. More than a million births have occurred under this programme. We studied women's perceptions of quality of care in the private CY facilities, conducting 30 narrative interviews between June 2012 and April 2013 with mothers who had birthed in 10 CY facilities within the last month. The commonly agreed upon characteristics of a "good (sari) delivery" were: giving birth vaginally, to a male child, with the shortest period of pain, and preferably free of charge. But all this mattered only after the primary outcome of being "saved" was satisfied. Women ensured this by choosing a competent provider, a "good doctor". They wanted a quick delivery by manipulating "heat" (intensifying contractions) through oxytocics. There were instances of inadequate clinical care for serious morbidities although the few women who experienced poor quality of care still expressed satisfaction with their overall care. Mothers' experiences during birth are more accurate indicators of the quality of care received by them, than the satisfaction they report at discharge. Improving health literacy of communities regarding the common causes of severe maternal morbidity and mortality must be addressed urgently. It is essential that cashless CY services be ensured to achieve the goal of 100% institutional births.
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Affiliation(s)
- Veena Iyer
- Associate Professor, PhD Candidate, Karolinska Institutet, Stockholm, Sweden; Indian Institute of Public Health Gandhinagar, Gujarat, India. Correspondence:
| | - Dileep Mavalankar
- Director, Indian Institute of Public Health Gandhinagar, Gujarat, India
| | - Rachel Tolhurst
- Reader in Social Science and International Health, Faculty of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Ayesha De Costa
- Associate Professor and University Lecturer, Karolinska Institutet, Stockholm, Sweden
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Marathe S, Hunter BM, Chakravarthi I, Shukla A, Murray SF. The impacts of corporatisation of healthcare on medical practice and professionals in Maharashtra, India. BMJ Glob Health 2020; 5:e002026. [PMID: 32133190 PMCID: PMC7042603 DOI: 10.1136/bmjgh-2019-002026] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/20/2019] [Accepted: 01/06/2020] [Indexed: 11/03/2022] Open
Abstract
A heterogeneous private sector dominates healthcare provision in many middle-income countries. In India, the contemporary period has seen this sector undergo corporatisation processes characterised by emergence of large private hospitals and the takeover of medium-sized and charitable hospitals by corporate entities. Little is known about the operations of these private providers and the effects on healthcare professions as employment shifts from practitioner-owned small and medium hospitals to larger corporate settings. This article uses data from a mixed-methods study in two large cities in Maharashtra, India, to consider the implications of these contemporary changes for the medical profession. Data were collected from semistructured interviews with 43 respondents who have detailed knowledge of healthcare in Maharashtra and from a witness seminar on the topic of transformation in Maharashtra's healthcare system. Transcripts from the interviews and witness seminar were analysed thematically through a combination of deductive and inductive approaches. Our findings point to a restructuring of medical practice in Maharashtra as training shifts towards private education and employment to those corporate hospitals. The latter is fuelled by substantial personal indebtedness, dwindling appeal of government employment, reduced opportunities to work in smaller private facilities and the perceived benefits of work in larger providers. We describe a 'reprofessionalisation' of medicine encompassing changes in employment relations, performance targets and constraints placed on professional autonomy within the private healthcare sector that is accompanied by trends in cost inflation, medical malpractice, and distrust in doctor-patient relationships. The accompanying 'restratification' within this part of the profession affords prestige and influence to 'star doctors' while eroding the status and opportunity for young and early career doctors. The research raises important questions about the role that government and medical professionals' bodies can, and should, play in contemporary transformation of private healthcare and the implications of these trends for health systems more broadly.
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Affiliation(s)
| | - Benjamin M Hunter
- Department of International Development, King's College London, London, UK
| | | | | | - Susan F Murray
- Department of International Development, King's College London, London, UK
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Creating health care consumers: The negotiation of un/official payments, power and trust in Russian maternity care. SOCIAL THEORY & HEALTH 2019. [DOI: 10.1057/s41285-019-00110-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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12
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Pandey SK, Sharma V. July 1 is National Doctors' Day: How to regain the lost public trust in healthcare? Indian J Ophthalmol 2018; 66:1045-1046. [PMID: 29941770 PMCID: PMC6032718 DOI: 10.4103/ijo.ijo_976_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Suresh K Pandey
- SuVi Eye Institute and Lasik Laser Center, Kota, Rajasthan, India
| | - Vidushi Sharma
- SuVi Eye Institute and Lasik Laser Center, Kota, Rajasthan, India
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Mirzoev T, Kane S. What is health systems responsiveness? Review of existing knowledge and proposed conceptual framework. BMJ Glob Health 2017; 2:e000486. [PMID: 29225953 PMCID: PMC5717934 DOI: 10.1136/bmjgh-2017-000486] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 10/06/2017] [Accepted: 10/11/2017] [Indexed: 11/05/2022] Open
Abstract
Responsiveness is a key objective of national health systems. Responsive health systems anticipate and adapt to existing and future health needs, thus contributing to better health outcomes. Of all the health systems objectives, responsiveness is the least studied, which perhaps reflects lack of comprehensive frameworks that go beyond the normative characteristics of responsive services. This paper contributes to a growing, yet limited, knowledge on this topic. Herewith, we review the current frameworks for understanding health systems responsiveness and drawing on these, as well as key frameworks from the wider public services literature, propose a comprehensive conceptual framework for health systems responsiveness. This paper should be of interest to different stakeholders who are engaged in analysing and improving health systems responsiveness. Our review shows that existing knowledge on health systems responsiveness can be extended along the three areas. First, responsiveness entails an actual experience of people’s interaction with their health system, which confirms or disconfirms their initial expectations of the system. Second, the experience of interaction is shaped by both the people and the health systems sides of this interaction. Third, different influences shape people’s interaction with their health system, ultimately affecting their resultant experiences. Therefore, recognition of both people and health systems sides of interaction and their key determinants would enhance the conceptualisations of responsiveness. Our proposed framework builds on, and advances, the core frameworks in the health systems literature. It positions the experience of interaction between people and health system as the centrepiece and recognises the determinants of responsiveness experience both from the health systems (eg, actors, processes) and the people (eg, initial expectations) sides. While we hope to trigger further thinking on the conceptualisation of health system responsiveness, the proposed framework can guide assessments of, and interventions to strengthen, health systems responsiveness.
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Affiliation(s)
- Tolib Mirzoev
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Sumit Kane
- KIT Royal Tropical Institute, Amsterdam, The Netherlands
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Pharmaceutical Promotion and Its Influence on Prescription Behavior: Ethical Issues and Legal Framework in India. Asian Bioeth Rev 2017. [DOI: 10.1007/s41649-017-0011-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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15
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Kalra S, Unnikrishnan AG, Baruah MP. Interaction, Information, Involvement (The 3I strategy): Rebuilding Trust in the Medical Profession. Indian J Endocrinol Metab 2017; 21:268-270. [PMID: 28459023 PMCID: PMC5367228 DOI: 10.4103/ijem.ijem_6_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
| | | | - Manash P. Baruah
- Department of Endocrinology, Excel Hospital, Guwahati, Assam, India
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