BACKGROUND Finland decentralised its universal healthcare system and introduced market reforms in the 1990s. Despite a commitment to equity, previous studies have identified persistent socio-economic inequities in healthcare, with patterns of service use that are more pro-rich than in most other European countries. To examine whether similar socio-economic patterning existed for mortality amena...

BACKGROUND Georgia's health care system underwent dramatic reform after gaining independence in 1991. The decentralization of the health care system was one of the core elements of health care reform but reports suggest that human resource management issues were overlooked. The Georgian national immunization program was affected by these reforms and is not functioning at optimum levels. This pa...

Historically, the self-suffi ciency of orthopedic surgeons has stretched beyond the limits of their profession and is a way of life. Autonomy in the choice of specialization, methodology, and practice setting has greatly infl uenced health care supply in the United States. However, at some point the interaction between businesspeople and health care providers transformed the focus of physicians...

INTRODUCTION Social work is a key member of interprofessional primary healthcare teams and foundational to primary healthcare reforms that aim to improve the provision of mental healthcare. Little is known, however, about social work's scope of practice within primary healthcare settings, particularly in the provision of mental healthcare. The objective of this study is to identify and describe...

BACKGROUND Whole-system interventions are those that entail system wide changes in goals, service delivery arrangements and relationships between actors, requiring approaches to implementation that go beyond projects or programmes. METHODS Drawing on concepts from complexity theory, this paper describes the catalysts to implementation of a whole-system intervention in the North West Province ...

BACKGROUND Patient and Public involvement (PPI) in health care occupies a central place in Western democracies. In England, this theme has been continuously prominent since the introduction of market reforms in the early 1990s. The health care reforms implemented by the current Coalition Government are making primary care practitioners the main commissioners of health care services in the Natio...

Profound changes are under way in Cuban medical education. Some aspects of this transformation represent radical shifts, others a deepening of processes already in motion. Together, these changes reflect a progressive sense of urgency over the last four decades to: 1) scale up physician training to meet the needs of the whole population; 2) recruit and train scientifically prepared and socially...

Five years have passed since the Future of Family Medicine report warned that the position of family medicine in the United States would be “untenable in 10 to 20 years unless changes occur in the broader health system and within the specialty.” To the casual observer, it may appear that not much has changed in five years, but family medicine leaders see a better future on the horizon. The focu...

1 An earlier version of this paper was prepared for the National Workshop on Women and Primary Health Care, which was held in February 2004 and was sponsored by Women and Health Care Reform (formerly the National Coordinating Group on Health Care Reform and Women), funded by Health Canada, and organized by Women and Health Care Reform and the Prairie Women’s Health Centre of Excellence in Winni...