International health and aid policies of the past two decades have had a major impact on the delivery of care in low and middle-income countries. This book argues that these policies have often failed to achieve their main aims, and have in fact contributed to restricted access to family medicine and hospital care. Presenting detailed evidence, and illustrated by case studies, this book describes how international health policies to date have largely resulted in expensive health care for the rich, and disjointed and ineffective services for the poor. As a result, large segments of the population world-wide continue to suffer from unnecessary casualties, pain and impoverishment. International Health and Aid Policies arms health professionals, researchers and policy makers with strategies that will enable them to bridge the gaps between public health, medicine and health policy in order to support robust, comprehensive and accessible health care systems in any political environment.
Jean-Pierre Unger is Senior Lecturer and co-director of the MPH programme at the Institute of Tropical Medicine, Antwerp, Belgium. Pierre De Paepe is a researcher at the Institute of Tropical Medicine, Antwerp, Belgium. Kasturi Sen is a social scientist at the Institute of Tropical Medicine, Antwerp, Belgium. Werner Soors is a researcher and teacher at the Institute of Tropical Medicine, Antwerp, Belgium.
Introduction: overview and purpose; Part I. Aspects of International Health Policies: 1. Donor led policies: analysis of an underlying doctrine; 2. The Achilles heel of international health policies in low and middle income countries; Part II. The Failure of the Aid Paradigm: Poor Disease Control in Developing Countries: 3. Why do disease control programs require patients in publicly-oriented services to succeed in delivering? The case of malaria control in Mali; 4. How do disease control programs damage health care delivery in developing countries?; 5. Privatization (PPM-DOTS) strategy for tuberculosis control: how evidence based is it?; Part III. International Health Policies and their Impact on Access to Health Care in Low and Middle Income Countries: Some Recent Experiences from Latin America: 6. Costa Rica: achievements of a heterodox health policy; 7. Colombia: in-vivo test of health sector privatization; 8. Chile's neo liberal health reforms: an assessment and a critique; Part IV. Determinants and Implications of New Liberal Health Policies: the Case of India, China and the Lebanon: 9. Political and economic determinants of health: the case of India; 10. An economic insight into health care in six Chinese counties: equity in crisis; 11. Health care financing and delivery in the context of conflict and crisis: the Lebanon; Part V. Principles for Publicly-Oriented Health Care Policies, Planning, Management and Delivery: 12. Paradigm shifts; Section 1. The need to alter health systems missions; Section 2. The need to change public health methods; 13. Principles for an alternative social and democratic health policy; 14. Quality standards for health care delivery and management in publicly-oriented health services; 15. Principles of publicly-oriented health planning; 16. A code of good practice for the management of disease control programs; Part VI. Strategies to Develop Publicly-Oriented Health Systems and Services: 17. Person-centered care in LIC/MIC publicly-oriented services; 18. Improving access; Section 1. Access to health care (Ecuador); Section 2. Access to drugs (Senegal); 19. Non-managed care techniques to improve clinical decision making; Section 1. Versatile techniques; Section 2. Interface flow-process audit; 20. Reorienting academic missions: how can public health departments best support access to good quality comprehensive health care?; Conclusion.