National Health Programs

The following paper describes a model project (currently in the trial phase at one clinic) focussing on empathetic communication within the family as an essential part of the treatment of mothers suffering from breast cancer and their children in order to activate the mother's self-healing powers and at the same time to prevent the children being traumatised as a consequence of the mother's illness.

The BEACH (Bettering the Evaluation and Care of Health) program, a continuous national study of general practice, began in April 1998 and is now in its eighth year. More than 7500 GPs have participated to date (about one-third of the total workforce) and data are available for about 750,000 encounters. The following overview is designed to disseminate key findings from BEACH, to publicize the annual report, and as a public expression of gratitude to the GP participants without whose generous contribution this study would not be possible.

In this paper we argue that the usual framework for evaluating health services may need modification in the context of a National Health Scheme (NHS). Some costs and benefits may need to be ignored or discounted, others included at face value, and some transfer payments included in the decision algorithm. In contrast with the standard framework, we argue that economic evaluation in the context of an NHS should focus on 'social transfers' between taxpayers and beneficiaries, and that the nature and scope of these transfers is determined by the level of social generosity.

National paid sick day and paid sick leave policies are compared in 22 countries ranked highly in terms of economic and human development. The authors calculate the financial support available to workers facing two different kinds of health problems: a case of the flu that requires missing 5 days of work, and a cancer treatment that requires 50 days of absence. Only 3 countries--the United States, Canada, and Japan--have no national policy requiring employers to provide paid sick days for workers who need to miss 5 days of work to recover from the flu.

The introduction of the New Cooperative Medical Scheme (NCMS) in rural China has been the most rapid and dramatic extension of health insurance coverage in the developing world in this millennium. The literature to date has mainly used the uneven rollout of NCMS across counties as a way of identifying its effects on access to care and financial protection. This study exploits the cross-county variation in NCMS generosity in 2006 and 2008 in the Ningxia and Shandong provinces to estimate the effect of coverage generosity on utilization and financial protection.

International differences in long-term care (LTC) use are well documented, but not well understood. Using comparable data from two countries with universal public LTC insurance, the Netherlands and Germany, we examine how institutional differences relate to differences in the choice for informal and formal LTC. Although the overall LTC utilization rate is similar in both countries, use of formal care is more prevalent in the Netherlands and informal care use in Germany.

In this article I discuss the role of money vis-‡-vis health care among the Dagomba, an agrarian people living in northern Ghana, whose pluralistic medical culture involves the use of both plants and Western pharmaceuticals in the treatment of various symptoms. In Dagomba society monetary exchanges in the domain of healing cannot be equated with self-interest, and nonmonetary exchanges cannot be compared with altruism in any straightforward fashion. Exchanges and their purposes are made meaningful by the contexts in which they occur. Exchanges may involve money and be commoditized.

Immunisation has proved a highly effective public health policy. However, it has come under public suspicion at times, with large falls in pertussis immunizations in the 1980s and smaller falls in measles, mumps and rubella (MMR) vaccine uptake recently. Immunisation scares have also occurred in other countries. This discussion paper explores the concepts of herd immunity, altruism, and informed consent. Historical, quantitative, and qualitative research on the sociology of immunisation is reviewed.

SETTING: Since 2005, private pharmacies linked to the National Tuberculosis Programme (NTP) and the Municipal Health Department in Phnom Penh have referred tuberculosis (TB) symptomatic patients to public sector TB clinics. OBJECTIVE: To investigate the attitudes and practices of pharmacy-initiated referral service providers in Phnom Penh from 2005 to 2010. METHODS: In a qualitative study, participants were purposively selected from the register of pharmacy owners providing referral services. Discussions were conducted in Khmer by trained facilitators.

To test the hypothesis that widespread treatment with artemisinin derivatives can reduce malaria transmission, a mass drug administration (MDA) campaign was undertaken in an area of The Gambia in 1999. Coverage of 85% of the target population was achieved, but the intervention did not reduce overall malaria transmission. We studied the perceptions, knowledge and attitudes of the community to the MDA campaign. A validated questionnaire was administered to randomly selected MDA participants (n = 90) and MDA refusers (n = 71).