On the 30th anniversary of Alma-Ata, the World Health Organization published in 2008 the "Primary Health Care Now More Than Ever" Report, calling on all governments to reflect on the need to reflect on four sets of reforms. These included: (i) universal coverage reforms; (ii) service delivery reforms; (iii) public policies reforms that would ensure healthier communities; and (iv) leadership ref...

This paper illustrates how advocates for gender equity succeeded in influencing the restructuring of the health system in Bangladesh in the mid-1990s but failed to influence its implementation. Using published and unpublished documents and personal interviews, it traces the changing fortunes of health sector reforms and reform advocates from 1995 to 2002 and analyses the major challenges and st...

BACKGROUND National community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significant challenges to the integration and support of such programmes, and they require coordination and stewardship at all levels of the health system. This paper explores the leaders...

This article explores the complexity of a health care system reforms in a post-conflict situation. It describes how the health care system was revamped immediately after the war, and then reorganized with Primary Health Care (PHC) as the fulcrum for change. It highlights the coordination problems, typical of a post-war situation when un-coordinated humanitarian assistance pours in. From the van...

This paper analyses the problem of sub-national revenue mobilization in Peru and proposes several policy reforms to improve collection performance while maintaining a sound revenue structure. We analyze the current revenues of regional and municipal governments and identify the main priorities of reform. Among the most important problems are the acute inequalities and inefficiencies associated ...

BACKGROUND Telemedicine services are considered essential for improving the accessibility, quality and efficiency of the healthcare services in developing countries. With these expectations, government of Nepal has implemented a rural-telemedicine program in thirty peripheral district hospitals to improve the accessibility of specialist health services. Telemedicine can be appropriate to the na...

After undergoing many changes, the financing of health care in countries of the former Soviet Union is now showing signs of maturing. Soon after the political transition in these countries, the development of insurance systems and fee-for-service payment systems dominated the discussions on health reform. At present there is increasing emphasis on case mix adjusted payments in larger hospitals ...