Implementation of newborn hearing screening in Rizal, Philippines, and Northern California: Lessons learned

Objective@#The universal newborn hearing screening program has been implemented in the Philippines for the past ten years. However, screening rates in the country are still low. The current study aimed to describe the universal newborn hearing screening program (UNHSP) delivery system in Rizal, Philippines, and Northern California. @*Methods@#The study utilized a case study research design using data triangulation of FGD, KII, and document review to characterize and compare the implementation of the Universal Newborn Hearing Screening Program in Rizal Province and Northern California. @*Results@#Several differences were found in the protocols for newborn hearing screening in Rizal, Philippines, and Northern California, including centralization of the program, availability of surveillance data, screening protocols, and tracking system. @*Conclusion@#There is an immense need to disseminate universal newborn hearing screening among healthcare practitioners and create a system to monitor and evaluate real-time data.

Examining the oral health of Filipinos: Policy analysis

Background@#High prevalence of oral health problems persists across all age groups among Filipinos despite the continued endeavors of the government and professional societies. This position statement aimed to generate consensus policy recommendations to protect and promote oral health in the Philippines as an integral part of the healthcare service in light of the Universal Health Care (UHC) Act. @*Methods@#An evidence-based policy brief and presentations of dental and policy experts were used as discussion points in the roundtable discussion conducted by the UP Manila Health Policy Development Hub. Key stakeholders from various sectors were convened to generate inputs for policy actions and amendments to oral health related policies. ools.@*Results@#Thematic analysis of the discussion was organized using the WHO Building Blocks of Health Systems, which yielded practical, accessible, and population-wide interventions (2010). The following issues were highlighted: (a) health service delivery needs strong collaboration of LGUs; (b) insufficient workforce of dental professionals; (c) market availability of sufficiently fluoridated toothpaste per age group; and (d) health financing scheme on oral health services.@*Conclusion and Recommendations@#With the shift in the health system landscape brought by the UHC Act, timely and responsive inter-sectoral interventions, focusing on prevention, must be set to attain the target decrease in the prevalence of dental caries. It was also to recommend to (i) engage the academe and training institutions to increase the workforce, (ii) consider adopting international standards on sugar consumption as appropriate, and (iii) ensure sufficient funds for sustainability of oral health programs, particularly school-based caries prevention program starting in pre-schools.

Implementación, resultados iniciales y sostenibilidad de la reforma de servicios de salud mental en el Perú, 2013-2018 / Implementation, initial results, and sustainability of the mental health services reform in Peru, 2013-2018

RESUMEN Se analiza la implementación, resultados iniciales y sostenibilidad de innovaciones en la prestación, financiamiento y gestión de servicios de salud mental en el Perú, realizadas en el periodo 2013-2018. Aplicando nuevos mecanismos de financiamiento y estrategias de gestión pública se implementaron 104 Centros de Salud Mental Comunitarios y ocho Hogares Protegidos que muestran ser más eficientes que los hospitales psiquiátricos. El conjunto de los 29 centros creados entre 2015 y 2017, produjeron en el 2018 un número equivalente en atenciones (244 mil vs. 246 mil) y atendidos (46 mil vs. 48 mil) que el conjunto de los tres hospitales psiquiátricos, pero con el 11% de financiamiento y el 43% de psiquiatras. Se está cambiando la forma de atender la salud mental en el Perú involucrando a ciudadanos y comunidades en el cuidado continuo y creando mejores condiciones para el ejercicio de los derechos en salud mental. La reforma en salud mental comunitaria ha ganado amplio respaldo de sectores políticos, internacionales, académicos y medios de comunicación. Se concluye que la reforma de los servicios de salud mental de base comunitaria en el Perú es viable y sostenible. Está en condiciones para escalar a todo el sector salud en todo el territorio nacional, sujeto al compromiso de las autoridades, el incremento progresivo de financiamiento público y las estrategias colaborativas nacionales e internacionales.

ABSTRACT This paper analyzes the implementation, initial results, and sustainability of innovations in the provision, financing, and management of mental health services in Peru, carried out during 2013-2018. By applying new financing mechanisms and public management strategies, 104 Community Mental Health Centers and eight Protected Homes were implemented, which prove to be more efficient than psychiatric hospitals. The set of 29 centers created between 2015 and 2017 produced in 2018 an equivalent number in consultations (244,000 vs. 246,000) and patients attended (46,000 vs. 48,000) than the set of three psychiatric hospitals, but with 11% of financing and 43% of psychiatrists. The way mental health care is being provided is changing in Peru by involving citizens and communities in ongoing care and creating better conditions for the exercise of mental health rights. Community mental health reform has gained broad support from political, international, and academic sectors, and from the media. We conclude that the reform of community-based mental health services in Peru is viable and sustainable. It is in a position to scale up the entire health sector throughout the country, subject to the commitment of the authorities, the progressive increase in public financing, and national and international collaborative strategies.

A Study of the Current State of the Mental Health Service Delivery System Using the Focused-Group Interview / 신경정신의학

OBJECTIVES: To use focus-group interviews (FGI) to determine the current state of the Korean mental health service delivery system, inter-agency patient links, and identify associated problems. METHODS: The FGI were conducted by seven workers from psychiatric rehabilitation centers and community mental health centers and seven social workers from mental health hospitals. RESULTS: Within the mental health service delivery system, disconnection of the community network after discharge is considered a serious problem. The following improvement proposals are suggested : 1) the control tower should govern the community network after discharge, 2) consider insurance costs during activation of hospital links, and 3) expand information sharing related to community social facilities. With regard to non-voluntary admission and long-term hospitalization, most focus group members considered the revolving-door phenomenon to be more serious than non-voluntary admission. In order to prevent unnecessary long-term hospitalization, the FGI results indicated that the government should proactively intervene in the admission/discharge process. In addition, the following improvement proposals were suggested : 1) functional activation of the mental health review board via the reinforcement of workers' expertise, 2) expansion of local mental health centers, and 3) undertake institutional changes related to the family-related issue of preferring hospitalization over a stay at a secure facility. CONCLUSION: For the government to improve the efficiency of the mental health service delivery system, it is necessary to improve institutional linkages, expand mental health infrastructure, and develop an integrated management system.

The Concept and Challenges for Public Health Systems / 보건행정학회지

The study of public health systems is an important, but very difficult task. The concept and functions of public health systems are influenced by the views, interests, and influence of the various stakeholders belonging to public health systems and broader social, economic, political, and environmental sectors. To define public health system with conceptual clarification, we must take into account the dynamic and complex aspect of the public health system. This paper reviews health systems and public health systems literature to suggest the concept, goals, and functions of public health systems. In addition, this paper recognizes some challenges, such as leadership and management, resource development, economic support, and service delivery to strengthen public health systems for improving health and well-being of population.

Development of healthcare system in Macao and its implications for China's mainland / 中华医院管理杂志

This paper introduced the latest healthcare management and the service delivery system including health resources in Macao,highlighting the developed legal system,government financing policies for health sector,the well-developed medical service referral system,favorable development supports for private medical institutions,and remuneration incentive policies for health workers in Macao.These may serve as the useful implications and recommendations for health reform and development in mainland of China.

A regulação no setor público de saúde no Brasil: os (des) caminhos da assistência médico-hospitalar / Regulation in the public health sector in Brazil: the (mis) direction of hospital care provision

A regulação é uma função pública imprescindível para garantir maior efetividade às ações desenvolvidas pelos sistemas de saúde. Nesse estudo, são analisados os principais instrumentos de regulação da assistência à saúde criada pelo Sistema Único de Saúde (SUS), vis-à-vis a evolução histórica da prestação de serviços hospitalares entre 1996 e 2006. Apesar das mudanças políticas e organizacionais exigidas pelo processo de reforma sanitária na implementação do SUS, e dos avanços detectados, evidências e dados empíricos sugerem incipiência e fragilidade dos mecanismos de regulação pactuados, que não foram capazes de mudar os padrões históricos e as características gerais da assistência hospitalar no SUS. O artigo apresenta uma possibilidade explicativa preliminar para a ação de grupos de interesse que teriam participado ativamente do processo de regulação, canalizando recursos públicos para os segmentos dos prestadores privados e filantrópicos de serviços assistenciais, que atuam no setor saúde brasileiro há décadas e se perpetuaram no SUS, distorcendo o processo de implementação do sistema e a prestação de serviços de alta relevância para a sociedade brasileira.

Health care regulation is a fundamental action in order to achieve effectiveness in health system. This article analyses SUS [Unified Health System] main regulatory framework, in relation to historical patterns of health service delivery, observed between 1996 and 2006. Despite all those political and organizational changes required by the Brazilian health sector reform process to implement SUS, which progressed, evidences and empirical data suggest that the agreed regulatory frameworks are weak and fragile and they did not change historical patterns and the main characteristics of SUS health care. This article suggests one possible explanatory reason for this behaviour, that needs to be empirically analysed: interest groups acting inside the Brazilian health system, on behalf of social insurance health care network, could capture the regulatory process, taking public resources to this network which maintain the same pattern of heath care services for decades, jeopardizing SUS implementation and the relevant health service delivery for the Brazilian society.