Disintegrated care: the Achilles heel of international health policies in low and middle-income countries
Identifieur interne : 007998 ( Main/Exploration ); précédent : 007997; suivant : 007999Disintegrated care: the Achilles heel of international health policies in low and middle-income countries
Auteurs : Jean-Pierre Unger ; Pierre De Paepe ; Patricia Ghilbert ; Werner Soors ; Andrew GreenSource :
- International Journal of Integrated Care [ 1568-4156 ] ; 2006.
Abstract
To review the evidence basis of international aid and health policy.
Current international aid policy is largely neoliberal in its promotion of commoditization and privatisation. We review this policy's responsibility for the lack of effectiveness in disease control and poor access to care in low and middle-income countries.
National policies, international programmes and pilot experiments are examined in both scientific and grey literature.
We document how health care privatisation has led to the pool of patients being cut off from public disease control interventions—causing health care disintegration—which in turn resulted in substandard performance of disease control.
Privatisation of health care also resulted in poor access. Our analysis consists of three steps. Pilot local contracting-out experiments are scrutinized; national health care records of Colombia and Chile, two countries having adopted contracting-out as a basis for health care delivery, are critically examined against Costa Rica; and specific failure mechanisms of the policy in low and middle-income countries are explored.
We conclude by arguing that the negative impact of neoliberal health policy on disease control and health care in low and middle-income countries justifies an alternative aid policy to improve both disease control and health care.
Url:
PubMed: 17006553
PubMed Central: 1576566
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Disintegrated care: the Achilles heel of international health policies in low and middle-income countries</title><author><name sortKey="Unger, Jean Pierre" sort="Unger, Jean Pierre" uniqKey="Unger J" first="Jean-Pierre" last="Unger">Jean-Pierre Unger</name></author><author><name sortKey="De Paepe, Pierre" sort="De Paepe, Pierre" uniqKey="De Paepe P" first="Pierre" last="De Paepe">Pierre De Paepe</name></author><author><name sortKey="Ghilbert, Patricia" sort="Ghilbert, Patricia" uniqKey="Ghilbert P" first="Patricia" last="Ghilbert">Patricia Ghilbert</name></author><author><name sortKey="Soors, Werner" sort="Soors, Werner" uniqKey="Soors W" first="Werner" last="Soors">Werner Soors</name></author><author><name sortKey="Green, Andrew" sort="Green, Andrew" uniqKey="Green A" first="Andrew" last="Green">Andrew Green</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">17006553</idno><idno type="pmc">1576566</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1576566</idno><idno type="RBID">PMC:1576566</idno><date when="2006">2006</date><idno type="wicri:Area/Pmc/Corpus">003F62</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003F62</idno><idno type="wicri:Area/Pmc/Curation">003F61</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">003F61</idno><idno type="wicri:Area/Pmc/Checkpoint">003C85</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">003C85</idno><idno type="wicri:Area/Ncbi/Merge">002421</idno><idno type="wicri:Area/Ncbi/Curation">002421</idno><idno type="wicri:Area/Ncbi/Checkpoint">002421</idno><idno type="wicri:Area/Main/Merge">007B85</idno><idno type="wicri:Area/Main/Curation">007998</idno><idno type="wicri:Area/Main/Exploration">007998</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Disintegrated care: the Achilles heel of international health policies in low and middle-income countries</title><author><name sortKey="Unger, Jean Pierre" sort="Unger, Jean Pierre" uniqKey="Unger J" first="Jean-Pierre" last="Unger">Jean-Pierre Unger</name></author><author><name sortKey="De Paepe, Pierre" sort="De Paepe, Pierre" uniqKey="De Paepe P" first="Pierre" last="De Paepe">Pierre De Paepe</name></author><author><name sortKey="Ghilbert, Patricia" sort="Ghilbert, Patricia" uniqKey="Ghilbert P" first="Patricia" last="Ghilbert">Patricia Ghilbert</name></author><author><name sortKey="Soors, Werner" sort="Soors, Werner" uniqKey="Soors W" first="Werner" last="Soors">Werner Soors</name></author><author><name sortKey="Green, Andrew" sort="Green, Andrew" uniqKey="Green A" first="Andrew" last="Green">Andrew Green</name></author></analytic><series><title level="j">International Journal of Integrated Care</title><idno type="eISSN">1568-4156</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><sec id="st1"><title>Purpose</title><p>To review the evidence basis of international aid and health policy.</p></sec><sec id="st2"><title>Context of case</title><p>Current international aid policy is largely neoliberal in its promotion of commoditization and privatisation. We review this policy's responsibility for the lack of effectiveness in disease control and poor access to care in low and middle-income countries.</p></sec><sec id="st3"><title>Data sources</title><p>National policies, international programmes and pilot experiments are examined in both scientific and grey literature.</p></sec><sec id="st4"><title>Conclusions and discussion</title><p>We document how health care privatisation has led to the pool of patients being cut off from public disease control interventions—causing health care disintegration—which in turn resulted in substandard performance of disease control.</p><p>Privatisation of health care also resulted in poor access. Our analysis consists of three steps. Pilot local contracting-out experiments are scrutinized; national health care records of Colombia and Chile, two countries having adopted contracting-out as a basis for health care delivery, are critically examined against Costa Rica; and specific failure mechanisms of the policy in low and middle-income countries are explored.</p><p>We conclude by arguing that the negative impact of neoliberal health policy on disease control and health care in low and middle-income countries justifies an alternative aid policy to improve both disease control and health care.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Walt, G" uniqKey="Walt G">G Walt</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Walsh, Ja" uniqKey="Walsh J">JA Walsh</name></author><author><name sortKey="Warren, Ks" uniqKey="Warren K">KS Warren</name></author></analytic></biblStruct><biblStruct><analytic><author><name 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last="Ghilbert">Patricia Ghilbert</name><name sortKey="Green, Andrew" sort="Green, Andrew" uniqKey="Green A" first="Andrew" last="Green">Andrew Green</name><name sortKey="Soors, Werner" sort="Soors, Werner" uniqKey="Soors W" first="Werner" last="Soors">Werner Soors</name><name sortKey="Unger, Jean Pierre" sort="Unger, Jean Pierre" uniqKey="Unger J" first="Jean-Pierre" last="Unger">Jean-Pierre Unger</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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|texte= Disintegrated care: the Achilles heel of international health policies in low and middle-income countries
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