Int J Health Serv
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Several recent papers find evidence that global health aid is being diverted to reserves, education, military, or other sectors, and is displacing government spending. This is suggested to occur because ministers of finance have competing, possibly corrupt, priorities and deprive the health sector of resources. Studies have found that development assistance for health routed to governments has a negative impact on health spending and that similar assistance routed to private nongovernmental organizations has a positive impact. ⋯ However, evaluating IMF-borrowing versus non-IMF-borrowing countries reveals that non-borrowers add about $0.45 whereas borrowers add less than $0.01 to the health system. On average, health system spending grew at about half the speed when countries were exposed to the IMF than when they were not. It is important to take account of the political economy of global health finance when interpreting data on financial flows.
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The health of Aboriginal people is significantly worse than that of the rest of the Australian population. Aboriginal community-controlled health organizations live with uncertainty in terms of funding, and the amount of money spent on indigenous people through mainstream health services is less than that spent on the non-indigenous population, especially when the different needs of these two groups are taken into account. The Aboriginal population is small and widely dispersed, causing problems for policy and funding. ⋯ The research approach involved semi-structured interviews with informants from a range of health organizations within the state. This research illustrates the importance of Aboriginal community-controlled health organizations to the indigenous community. There is evidence that connections between the indigenous and mainstream health systems need to be further developed and strengthened to provide the indigenous population with a high-quality, culturally sensitive, and comprehensive health service.
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In a two-part article (the first part in this Journal issue), the author explores the prospects for a genuine revival of the social justice project of "Health for All by the Year 2000", launched by the WHO and UNICEF in 1978 at Alma-Ata in the former Soviet Union, with reference (in Part I) to the World Health Report 2008, Primary Health Care: Now More than Ever, and the report of the WHO Commission on Social Determinants of Health, also published in 2008; and (in Part II) to Global Health Watch 2: An Alternative World Health Report and the perspectives of anti-capitalist, real socialist, environmental, and people's movements for economic and social justice. The reports are reviewed in terms of the original values and principles of Alma-Ata (social justice and human rights) and the structural foundations of the primary health care (PHC) project (a new international economic order and emancipatory development of decolonized countries). A genuine revival of the PHC project and of Health for All, which is its implicit objective, will not be possible unless the multiple crises that we are confronting today-in energy, water, food, finance, the environment, science, information, and democracy-are recognized as capitalist crises and addressed in these terms. In short, the invisible hand of the market must be replaced by the visible hand of social justice.
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This article presents an update on the characteristics and performance of Venezuela's Bolivarian health care system, Barrio Adentro (Inside the Neighborhood). During its first five years of existence, Barrio Adentro has improved access and utilization of health services by reaching approximately 17 million impoverished and middle-class citizens all over Venezuela. ⋯ Examination of a few epidemiological indicators for the years 2004 and 2005 of Barrio Adentro reveals the positive impact of this health care program, in particular its primary care component, Barrio Adentro I. Continued political commitment and realistic evaluations are needed to sustain and improve Barrio Adentro, especially its primary care services.
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The conservative government that came to power in Sweden in 2006 has initiated major market-oriented reforms in the health sector. Its first health care policy bill changed the health legislation to make it possible to sell/transfer public hospitals to commercial providers while maintaining public funding. Far-reaching market-oriented primary health care reforms are also initiated, for example in Stockholm County. ⋯ Furthermore, dynamic market forces will gradually reduce the quality of care in low-income areas while both access and quality of care will be even better in high-income areas. Public funds are thus transferred from people living in low-income areas to people living in high-income areas, even though the need for good health services is much greater in the low-income areas. Certain policy options for reversing the inverse law of care are also presented.