Suchergebnisse

Cover -- Title -- Copyright -- Dedication -- Contents -- List of figures -- List of tables -- List of abbreviations -- Preface -- 1 Quantitative environmental health -- 2 Uncertainty, social science and the role of theory -- 3 How certain is the cost or benefit? Can it be made safe? -- 4 Is it likely to happen? -- 5 Risk is everywhere -- 6 Is the risk reversible? -- 7 Delayed risk, exposures and health outcomes -- 8 Who suffers most and what can be done? -- 9 Evaluating environmental risks to health -- 10 And more of the same? -- Index

This book considers the social and geographical context in which the National Health Service (NHS) operated during the 1970s and 1980s. It argues that disease and health care systems are the product to a large degree of the wider social and cultural context. It explores the relationship between health, work, poverty, housing, class and culture.examines how resource allocation and social policies are determined by the wider social and cultural context.discusses how the health of the nation, broadly defined should best be managed. As relevant today as when it was originally published, comments o

Abstract Background Universal Health Coverage (UHC) has emerged as a major goal for health care delivery in the post-2015 development agenda. It is viewed as a solution to health care needs in low and middle countries with growing enthusiasm at both national and global levels. Throughout the world, however, the paths of countries to UHC have differed. South Africa is currently reforming its health system with UHC through developing a national health insurance (NHI) program. This will be practically achieved through a decentralized approach, the district health system, the main vehicle for delivering services since democracy. Methods We utilize a review of relevant documents, conducted between September 2014 and December 2015 of district health systems (DHS) and UHC and their ideological underpinnings, to explore the opportunities and challenges, of the district health system in achieving UHC in South Africa. Results Review of data from the NHI pilot districts suggests that as South Africa embarks on reforms toward UHC, there is a need for a minimal universal coverage and emphasis on district particularity and positive discrimination so as to bridge health inequities. The disparities across districts in relation to health profiles/demographics, health delivery performance, management of health institutions or district management capacity, income levels/socio-economic status and social determinants of health, compliance with quality standards and above all the burden of disease can only be minimised through positive discrimination by paying more attention to underserved and disadavantaged communities. Conclusions We conclude that in South Africa the DHS is pivotal to health reform and UHC may be best achieved through minimal universal coverage with positive discrimination to ensure disparities across districts in relation to disease burden, human resources, financing and investment, administration and management capacity, service readiness and availability and the health access inequalities are consciously implicated. Yet ideological and practical issues make its achievement problematic.

In multiple jurisdictions, diverse stakeholders are increasingly challenging where, how, and by whom environmental health risks from chemicals should be governed. Using the case of Bisphenol A assessed under Canada's Chemicals Management Plan, we analyse how political and epistemic legitimacy is being (re)configured, situated, and contested. We conceptually integrate distinct literatures on 'politics of scale', 'scale frames' and 'boundary work' to examine the role of socio-spatial processes in shaping 'legitimate' expertise, evidence, and policy action. Textual documents and key informant interviews reveal disputes over 'scaling' perceived risk problems, constituent variables, requisite expertise, interventions and associated interrelationships with legislative and scientific 'boundary-objects' produced through hybrid deliberations. Tensions over distinguishing the role of stakeholder knowledge and impartial expertise, and differentiated access given to technical details and normative rationales driving the operationalisation of regulatory/scientific principles are discussed. Stakeholders seeking to shape policy must gain the legitimacy to access jurisdictional and epistemic spaces in which knowledge, evidence, and rationales become institutionalised. Adapted from the source document.