Browsing 2016 fellows by Title
Now showing items 1-20 of 22
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Associations between structures and resources of primary care at the district level and health outcomes: a case study of diabetes mellitus care in Thailand
(2018-10-26)
Background: The structural factors of primary care potentially influence its performance and quality. This study investigated the association between structural factors, including available primary care resources and health outcomes, by using diabetes-related ambulatory care sensitive conditions hospitalizations under the Universal Coverage Scheme in Thailand. Methods: A 2-year panel study used secondary data compiled at the district level. Administrative claim data from 838 districts during the 2014–2015 fiscal years from the National Health ... -
Breaking down the barriers: Understanding migrant workers' access to healthcare in Malaysia
(2019-07-03)
Background: Malaysia is widely credited to have achieved universal health coverage for citizens. However, the accessibility of healthcare services to migrant workers is questionable. Recently, medical fees for foreigners at public facilities were substantially increased. Mandatory health insurance only covers public hospital admissions and excludes undocumented migrants. This study explores barriers to healthcare access faced by documented and undocumented migrant workers in Malaysia. Methods: We use qualitative data from 17 in-depth ... -
Can mHealth and eHealth improve management of diabetes and hypertension in a hard-to-reach population? —lessons learned from a process evaluation of digital health to support a peer educator model in Cambodia using the RE-AIM framework
(2020-10-05)
Background: The burden of non-communicable diseases (NCDs) is increasing in low- and middle-income countries (LMICs) where NCDs cause 4:5 deaths, disproportionately affect poorer populations, and carry a large economic burden. Digital interventions can improve NCD management for these hard-to-reach populations with inadequate health systems and high cell-phone coverage; however, there is limited research on whether digital health is reaching this potential. We conducted a process evaluation to understand challenges and successes from a digital ... -
Developing an evidence assessment framework and appraising the academic literature on migrant health in Malaysia: a scoping review
(2020-12-09)
Background: A large number of international migrants in Malaysia face challenges in obtaining good health, the extent of which is still relatively unknown. This study aims to map the existing academic literature on migrant health in Malaysia and to provide an overview of the topical coverage, quality and level of evidence of these scientific studies. Methods: A scoping review was conducted using six databases, including Econlit, Embase, Global Health, Medline, PsycINFO and Social Policy and Practice. Studies were eligible for inclusion if ... -
Governance of Assisted Living in Singapore: Lessons for Aging Countries
(2022-06-14)
A global trend toward aging populations means that the challenge of providing adequate long-term care to older people looms large in many countries. In Singapore, a public discourse revolving around the expansion of assisted living to create age-friendly environments in long-term care has emerged. This study examines Singapore's experience in developing regulations for assisted living by documenting the different levels of regulation in place and by identifying the regulatory gaps remaining to govern assisted living. Anchoring in a conceptual ... -
Health financing policies during the COVID-19 pandemic and implications for universal health care: a case study of 15 countries
(2023-12)
Background: The COVID-19 pandemic was a health emergency requiring rapid fiscal resource mobilisation to support national responses. The use of effective health financing mechanisms and policies, or lack thereof, affected the impact of the pandemic on the population, particularly vulnerable groups and individuals. We provide an overview and illustrative examples of health financing policies adopted in 15 countries during the pandemic, develop a framework for resilient health financing, and use this pandemic to argue a case to move towards ... -
Healthcare for migrant workers in destination countries: a comparative qualitative study of China and Malaysia
(2020-11-09)
Objectives: This paper explores policies addressing migrant worker’s health and barriers to healthcare access in two middle-income, destination countries in Asia with cross-border migration to Yunnan province, China and international migration to Malaysia. Design: Qualitative interviews were conducted in Rui Li City and Tenchong County in Yunnan Province, China (n=23) and Kuala Lumpur, Malaysia (n=44), along with review of policy documents. Data were thematically analysed. Participants: Participants were migrant workers and key stakeholders ... -
How Management and Leadership Training Can Impact a Health System: Evaluation Findings From a Public Health Management Training Program in Cambodia
(2022-01-26)
In 2017, the National Institute of Public Health in Cambodia collaborated with the U.S. Centers for Disease Control and Prevention to provide management and leadership training for 20 managers and senior staff from 10 health centers. We conducted a mixed methods evaluation of the program's outcomes and impact on the graduates and health centers. From June 2018 (baseline) to January 2019 (endpoint), we collected data from a competency assessment, observational visits, and interviews. From baseline to endpoint, all 20 participants reported increased ... -
Human resources for health: task shifting to promote basic health service delivery among internally displaced people in ethnic health program service areas in eastern Burma/Myanmar
(2014-09-29)
Background: Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ... -
International Trade Agreements and Impact on the Medicine System: Causal Relations?
(2020-01-27)
This article comprehensively reviews and analyses knowledge and information relating to international trade agreements and their implications during the past 17 years, both within and external to Thailand. To reveal the implications and impact systematically, the conceptual framework for analysis was drafted and the implications were mapped along the medicine value chain. The mapping shows cross-link of the implications and took concerns of health sectors. Focusing on medicines, despite of positive impact, international trade agreements have had ... -
Lessons from India and Thailand for Cambodia's Future Implementation of the TRIPS Agreement for Pharmaceutical Patents
(2023-03-07)
Cambodia is expected to graduate from least developed country (LDC) status in the near future, at which time it will be required to make patents available for pharmaceutical products and processes to meet its obligations under the Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS). Given its impending transition from LDC status, there is a need to balance Cambodia's intellectual property (IP) policies and regulations with public health priorities to ensure access to affordable life‐saving medicines. This will be critical ... -
Making free public healthcare attractive: optimizing health equity funds in Cambodia
(2018-06-25)
Background: Following the introduction of user fees in Cambodia, Health Equity Funds (HEF) were developed to enable poor people access to public health services by paying public health providers on their behalf, including non-medical costs for hospitalised beneficiaries (HEFB). The national scheme covers 3.1 million pre-identified HEFB. Uptake of benefits, however, has been mixed and a substantial proportion of poor people still initiate care at private facilities where they incur considerable out-of-pocket costs. We examine the benefits of ... -
Measuring health equity in the ASEAN region: conceptual framework and assessment of data availability
(2023-12-05)
Background: Existing research on health equity falls short of identifying a comprehensive set of indicators for measurement across health systems. Health systems in the ASEAN region, in particular, lack a standardised framework to assess health equity. This paper proposes a comprehensive framework to measure health equity in the ASEAN region and highlights current gaps in data availability according to its indicator components. Methods: A comprehensive literature review was undertaken to map out a core set of indicators to evaluate health ... -
Migrant Women’s Access to Sexual and Reproductive Health Services in Malaysia: A Qualitative Study
(2020-07-26)
Abstract Providing sexual and reproductive health (SRH) services to migrant workers is key to fulfilling sustainable developmental goals. This study aims to explore key informants’ views on the provision of SRH services for migrant women in Malaysia, exploring the provision of SRH education, contraception, abortion, antenatal and delivery, as well as the management of gender-based violence. In-depth interviews of 44 stakeholders were conducted from July 2018 to July 2019. Data were thematically analysed. Migrant workers that fall pregnant are ... -
Mitigating the impacts of the COVID-19 pandemic on vulnerable populations: Lessons for improving health and social equity
(2023-06-02)
The COVID-19 pandemic had an inequitable and disproportionate impact on vulnerable populations, reversing decades of progress toward healthy populations and poverty alleviation. This study examines various programmatic tools and policy measures used by governments to support vulnerable populations during the pandemic. A comparative case study of 15 countries representing all World Health Organization's regions offers a comprehensive picture of countries with varying income statuses, health system arrangements and COVID-19 public health measures. ... -
Moving towards culturally competent health systems for migrants? Applying systems thinking in a qualitative study in Malaysia and Thailand
(2020-04-06)
Cultural competency describes interventions that aim to improve accessibility and effectiveness of health services for people from ethnic minority backgrounds. Interventions include interpreter services, migrant peer educators and health worker training to provide culturally competent care. Very few studies have focussed on cultural competency for migrant service use in Low- and Middle-Income Countries (LMIC). Migrants and refugees in Thailand and Malaysia report difficulties in accessing health systems and discrimination by service providers. ... -
Progress toward universal health coverage in ASEAN
(2014-12-03)
Background: The Association of Southeast Asian Nations (ASEAN) is characterized by much diversity in terms of geography, society, economic development, and health outcomes. The health systems as well as healthcare structure and provisions vary considerably. Consequently, the progress toward Universal Health Coverage (UHC) in these countries also varies. This paper aims to describe the progress toward UHC in the ASEAN countries and discuss how regional integration could influence UHC. Design: Data reported in this paper were obtained from ... -
Qualitative evaluation of enabling factors and barriers to the success and sustainability of national public health institutes in Cambodia, Colombia, Liberia, Mozambique, Nigeria, Rwanda and Zambia
(2022-03-03)
Objectives: The success of National Public Health Institutes (NPHIs) in low-income and middle-income countries (LMICs) is critical to countries’ ability to deliver public health services to their populations and effectively respond to public health emergencies. However, empirical data are limited on factors that promote or are barriers to the sustainability of NPHIs. This evaluation explored stakeholders’ perceptions about enabling factors and barriers to the success and sustainability of NPHIs in seven countries where the U.S. Centers for Disease ... -
A qualitative study on gender barriers to eye care access in Cambodia
(2018-08-29)
Background: The Fred Hollows Foundation (FHF) Cambodia recently partnered with the Ministry of Women’s Affairs (MoWA) and National Program for Eye Health (NPEH, part of the Ministry of Health) to establish the Gender Equality in Eye Health Project. As part of this project, a qualitative study was carried out to identify barriers affecting women’s access to eye health in Cambodia. Methods: A cross-sectional qualitative study was conducted in four provinces in both urban and rural locations between May and June 2015. Purposive sampling was ...