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Good Health at Low Cost 25 years on: lessons for the future of health systems strengthening
- Publication Year :
- 2016
-
Abstract
- In 1985, the Rockefeller Foundation published Good health at low cost to discuss why some countries or regions achieve better health and social outcomes than do others at a similar level of income and to show the role of political will and socially progressive policies. 25 years on, the Good Health at Low Cost project revisited these places but looked anew at Bangladesh, Ethiopia, Kyrgyzstan, Thailand, and the Indian state of Tamil Nadu, which have all either achieved substantial improvements in health or access to services or implemented innovative health policies relative to their neighbours. A series of comparative case studies (2009-11) looked at how and why each region accomplished these changes. Attributes of success included good governance and political commitment, eff ective bureaucracies that preserve institutional memory and can learn from experience, and the ability to innovate and adapt to resource limitations. Furthermore, the capacity to respond to population needs and build resilience into health systems in the face of political unrest, economic crises, and natural disasters was important. Transport infrastructure, female empowerment, and education also played a part. Health systems are complex and no simple recipe exists for success. Yet in the countries and regions studied, progress has been assisted by institutional stability, with continuity of reforms despite political and economic turmoil, learning lessons from experience, seizing windows of opportunity, and ensuring sensitivity to context. These experiences show that improvements in health can still be achieved in countries with relatively few resources, though strategic investment is necessary to address new challenges such as complex chronic diseases and growing population expectations. Copyright © 2013 Elsevier B.V.
- Subjects :
- Institutional memory
health care delivery
Male
health status
geography
Health Services Accessibility
Good governance
case study
Medicine
Cooperative Behavior
Empowerment
media_common
education.field_of_study
Bangladesh
education
Health Policy
Environmental resource management
health care cost
General Medicine
Thailand
Organizational Innovation
income
priority journal
health care policy
Government
social aspect
Female
Psychological resilience
politics
medicine.medical_specialty
media_common.quotation_subject
Population
India
Development economics
Humans
human
Kyrgyzstan
Developing Countries
Poverty
Health policy
health care system
business.industry
Public health
financial management
economic aspect
empowerment
Ethiopia
business
Delivery of Health Care
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....892a5362c6cb4cc77bca61ec00f11438