Methods We provide a short history of health insurance in Ghana, and briefly discuss general patterns of enrolment in Ghana as well as in Accra in a first step. Results We find that on average individuals enrolled in the insurance scheme are significantly more likely to obtain prescriptions, visit clinics and seek formal health care when sick. Health insurance, health care utilisation, treatment differentials Introduction Health care financing in Ghana began with a tax-funded system that provided free public health care services to all after independence. As this system gradually became financially unsustainable with economic stagnation in the s, initially low user fees were established for hospital services to discourage unnecessary use, locally recover some costs and generate provider performance incentives.
Summary What is already known about this topic?
Inthe Public Health Accreditation Board launched the national, voluntary public health accreditation program as a strategy to advance the quality and performance of governmental public health departments. As of Maystate and local health departments have been accredited.
In addition, Florida, in which employees of all 67 local health departments are employees of the state, achieved accreditation for the entire integrated local public health department system in the state.
Collectively, nearly million persons, approximately half the U. What is added by this report? What are the implications for public health practice? Inthe nonprofit Public Health Accreditation Board PHAB launched the national, voluntary public health accreditation program for state, tribal, local, and territorial public health departments.
As of Mayhealth departments have achieved 5-year accreditation through PHAB and more have begun the formal process of pursuing accreditation.
In addition, Florida, a centralized state in which the employees of all 67 local health departments are employees of the state, achieved accreditation for the entire integrated local public health department system in the state.
PHAB-accredited health departments range in size from a small Indiana health department that serves approximately 17, persons to the much larger California Department of Public Health, which serves approximately 38 million persons.
Collectively, approximately half the U. Forty-two states and the District of Columbia now have at least one nationally accredited health department. The report discussed the need to strengthen public health infrastructure, and recommended accreditation as a potential strategy 1. With support from CDC and the Robert Wood Johnson Foundation, and participation by hundreds of public health practitioners and other technical experts, the first national accreditation program for health departments was developed 2.
PHAB was incorporated in Drawing on existing public health standards, and using a consensus process 3PHAB developed and tested a set of standards and measures organized around the 10 Essential Public Health Services. The amount of time health departments spend in preparation for accreditation will vary based on their readiness.
Once they determine they are ready, they submit an application, pay a fee based on the size of the population of the jurisdiction they serve, and provide documentation for each measure, including a community health assessment, a community health improvement plan, and an organizational strategic plan.
Volunteer peer site visitors review the documentation and assess its conformity with the measures. The PHAB Accreditation Committee reviews the site visit report and determines whether the applicant will be accredited at that time or be required to develop and implement an action plan 4.
Using this process, health departments in 45 states and the District of Columbia have applied for accreditation. Working with CDC and other national partners, PHAB is widely disseminating the benefits of accreditation to health departments and the communities they serve, and working to raise awareness about technical assistance and other resources to support the pursuit of accreditation.
Among other data collection and analysis strategies, NORC surveys health departments 1 year after they have been accredited. Data in this report were obtained from surveys sent to health departments quarterly throughout October —January Other accreditation benefits reported by accredited health departments that participated in focus groups and interviews include improved visibility, credibility, and reputation among their community partners, Board of Health, and public health peers within the state and nationally; improved identification and use of evidence-based programs and metrics; and increased cross-department collaboration.
In a focus group discussion with 12 accredited local health departments, participants described how accreditation provided an opportunity for their health department to evolve from one that only periodically used quality improvement to an organization that viewed improvement and data-driven performance management as part of standard operations.
Top Discussion Health departments undergoing the accreditation process report multiple benefits, including increased transparency, strengthened management processes, and improved ability to identify organizational weaknesses.
One of the foremost reported benefits is the increased use of quality improvement information in decision- making and in supporting a stronger culture of quality improvement. A report on a series of studies examining the response of public health decision-makers to accreditation, quality improvement, and public reporting initiatives suggests that quality improvement can strengthen implementation of evidence-based strategies and enhance the efficiency and effectiveness of public health programs 5.
Health departments also report that as a result of accreditation they communicate better with their governing entities.
Although this benefit is reported less frequently than some of the others, in response to an open-ended question, several health departments indicated that they might not have agreed that accreditation caused a specific change if the question related to an area in which they were already strong before applying.
This evaluation is the first to examine the impacts of the national public health accreditation program on quality improvement, management processes, and accountability. Those studies found that health departments participating in accreditation activities experienced benefits related to quality improvement and collaboration.
In addition, a series of case studies by applicant health departments highlights many of the same findings from the current evaluation, particularly the connection between accreditation and advancements in quality improvement 8.
The findings in this report are subject to at least three limitations. First, all survey data are self-reported and have not been verified independently.
Social desirability bias could result in respondents overreporting their quality improvement activities. Second, survey respondents are among the early adopters of accreditation. Although the health departments included in this study were diverse in size, geographic location, and structure, they might not be representative of all health departments.
Finally, because accreditation is a voluntary program, selection bias might apply.Oct 08, · Purpose. To examine whether National Institutes of Health (NIH) funded articles that were archived in PubMed Central (PMC) after the release of the NIH Public Access Policy show greater scholarly impact than comparable articles not archived in PMC.
NIH improves health by promoting treatment and prevention, contributes to society by driving economic growth and productivity, and expands the biomedical knowledge base by funding cutting-edge research and cultivating the biomedical workforce of today and tomorrow. Our Health Printer-friendly version of this page Discoveries emerging from NIH-funded research have led to new ways to treat, diagnose, and prevent illness, ultimately effecting the health of .
Nov 14, · Poor environmental quality has its greatest impact on people whose health status is already at risk. Therefore, environmental health must address the societal and environmental factors that increase the likelihood of exposure and disease.
We employ the introduction of the UK National Minimum Wage as a natural experiment. We estimate the causal impact of wage increases on mental health. We focus on low-wage earners who are at higher risk of mental ill-health. The National Institute of Environmental Health Sciences (NIEHS) is expanding and accelerating its contributions to scientific knowledge of human health and the environment, and to the health and well-being of people everywhere.