Search

Begin New Search Topic Health Care Policy Political Geography Asia

1. Not for Adults Only: Toward a Child’s Lens in Migration Policies in Asia

Author:
Maruja M. B. Asis and Alan Feranil
Publication Date:
03-2020
Content Type:
Journal Article
Journal:
Journal on Migration and Human Security
Institution:
Center for Migration Studies of New York
Abstract:
Having experienced substantial international migration since the 1970s, countries in East, South, and Southeast Asia have developed laws, institutions, policies, and programs to govern various aspects of international migration. Children, however, who comprise a significant share of the world’s international migrants, have not received as much policy attention as adults. Children are part of the region’s international migration experience (e.g., children left behind in the countries of origin when their parents migrate for work, children as migrants, and children as members of multicultural families). This article provides an overview of the challenges faced by children as migration actors, and the policy responses and programs that select countries in the region have developed to address children’s experiences and concerns. The Global Compact for Safe, Orderly and Regular Migration and the Global Compact on Refugees, which many Asian countries have endorsed, set forth objectives, commitments, and actions, informed by the principle of promoting the best interests of the child and child protection, which specifically address the needs of children. These include actions to promote universal birth registration, enhance access to education and health and social services regardless of migrant and legal status, and otherwise create inclusive and socially cohesive societies. Most countries in Asia have yet to meet these standards. Endorsing the two compacts was a first step. The good practices that have been implemented in a number of countries provide a template for how to translate these objectives into action and how to ensure that the full protection and best interests of migrant children, the left-behind children of migrant workers, and those who are part of multicultural families remain a priority.
Topic:
Migration, Regional Cooperation, Health Care Policy, and Children
Political Geography:
South Asia, East Asia, Asia, and Southeast Asia

2. Challenges and Responses to COVID-19: Experience from Asia

Author:
Nancy Davis Lewis and Jonathan D. Mayer
Publication Date:
07-2020
Content Type:
Commentary and Analysis
Institution:
East-West Center
Abstract:
Experience in Asia suggests that public health and medical capacity are critical for an effective response to an emerging infectious disease. Political will and previous experience with disease outbreaks also play a role. Singapore ignored an important segment of its population and is now experiencing a huge spike in cases. China and Vietnam were able to enforce draconian measures, while in Japan and Hong Kong, civil society had a greater role in initiating effective controls. In several countries, local political outcomes have been affected by the perceived success or failure of leaders in controlling the crisis.
Topic:
Health Care Policy, Leadership, Crisis Management, Public Health, and COVID-19
Political Geography:
Japan, China, Asia, Vietnam, Singapore, and Hong Kong

3. How can the NHS recruit and retain migrant nurses after Brexit?

Author:
Georgia Spiliopoulos and Stephen Timmons
Publication Date:
06-2019
Content Type:
Policy Brief
Institution:
Asia Research Institute, University of Nottingham
Abstract:
Non-British nurses working for the National Health Service (NHS) face a number of challenges, which must be addressed in the context of ongoing Brexit negotiations. Since the 2016 Referendum result to leave the European Union (EU), the number of EU nurses registering with the Nursing and Midwifery Council (NMC) plummeted in 2017 by 96% – from 1,304 EU nurses registering with the NMC in July 2016 to just 46 in April 2017 (Siddique, 2017). This drop in numbers is also linked with the number of EU nurses leaving the UK (Matthews-King, 2017). A recent NMC report (2019) published a 1% increase, for the first time in three years, in the number of new nurse registrants, for the period between April 2018 and March 2019. This increase translates into 6,000 nurses from the UK, EU and overseas. These numbers, while encouraging, reflect the changes in international recruitment from EU and non-EU countries, and importantly the impact of Brexit on the retention of both EU and non-EU nurses. This paper recommends measures to support the retention of these nurses.
Topic:
Health, Health Care Policy, Brexit, and Public Health
Political Geography:
Britain, United Kingdom, and Asia

4. How can the NHS recruit and retain migrant nurses after Brexit?: Background Report

Author:
Georgia Spiliopoulos and Stephen Timmons
Publication Date:
06-2019
Content Type:
Special Report
Institution:
Asia Research Institute, University of Nottingham
Abstract:
The UK Referendum decision to leave the European Union in June 2016 exacerbated some of the long-standing challenges the National Health Service (NHS) has been facing in recruiting and retaining nursing staff. In 2018, it was estimated that one in eight posts was vacant, which translates into 36,000 nursing vacancies (King’s Fund, 2018). Arguably, these challenges have been present since the founding of the NHS in 1948. Pre-established initiatives recruiting overseas nurses to deal with acute staffing shortages during the war effort, mainly from the Commonwealth, were also adopted by the NHS. Hence, the Nurses’ Act of 1949 relaxed the criteria for the registration of overseas nurses set up by the General Nursing Council (Solano and Rafferty, 2007). Therefore, we can trace historical developments in recruiting non-UK nurses, which reflect changing state regulations over time, connected to particular political and financial factors, xenophobic rhetoric and also problems in retaining British nursing staff (Bach, 2007; Ball, 2004; Cangiano et al, 2009; Simpkin and Mossialos, 2017; Solano and Rafferty, 2007). In the 1950s, for example, significant numbers of overseas nurses entered the UK as trainees, while an even higher number of British nurses emigrated abroad, fuelling concerns over training of overseas nurses but also bringing to the forefront anxieties over race (Solano and Rafferty, 2007). An illustrative example of political will influencing recruitment of overseas nurses was seen in New Labour’s push for a ‘modernization agenda’ in the late 1990s and subsequently, a push for international recruitment (Deeming, 2004). However, aggressive recruitment initiatives targeting nursing staff from developing countries such as Zimbabwe, Kenya and Zambia, led to the introduction of the NHS ‘Code of Practice’ on ethical recruitment in 2001 (Deeming, 2004), with calls for overseas recruitment to focus mainly on pre-existing agreements with countries such as the Philippines and India (Buchan, 2006).
Topic:
Health, Health Care Policy, Brexit, and Public Policy
Political Geography:
Britain, United Kingdom, and Asia

5. Modicare Post-Election: Recommendations to Enhance the Impact of Public Health Insurance on UHC Goals in India

Author:
Kalipso Chalkidou, Nishant Jain, Françoise Cluzeau, and Amanda Glassman
Publication Date:
05-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Hailed as one of the largest publicly funded health insurance programs in the world, India’s “Modicare” has, since its launch a little more than six months ago, made universal healthcare coverage an election theme for the first time in the country’s history.[1] In this note, we describe the program, with an emphasis on its better-known secondary and tertiary care component, and offer policy recommendations to strengthen the scheme post-election to enhance its contribution to India’s vision for universal health coverage (UHC). In a country of almost 1.4 billion people that is home to one-third of global maternal deaths, where public spending for health accounts for roughly 1 percent of GDP and where 60 million people fall into poverty every year because of healthcare bills, fixing healthcare is a daunting task that will determine the world’s performance against the Sustainable Development Goals over the coming decade.
Topic:
Health, Health Care Policy, Public Health, and Health Insurance
Political Geography:
India and Asia

6. Healing One-fifth of Humanity: Progress and Challenges for China’s Health System

Author:
Karen Eggleston
Publication Date:
10-2019
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
China’s national health reforms over the past two decades have brought the system closer to the modern, safe, reliable and accessible health system that is commensurate with China’s dramatic economic growth, improvement in living standards, and high hopes for the next generation. Celebrating a decade this year, China’s national health reforms of 2009 consolidated a system of social health insurance covering the entire population for basic health services, contributing to a surge in healthcare utilization while reducing out-of-pocket costs to patients – which declined from 56% to 28% of total health expenditures between 2003 and 2017. An expanded basic public health service package, funded by per capita government budget allocations that include a higher central government subsidy for lower income provinces, provides basic population health services to all Chinese. A higher percentage of Chinese accessed hospital admissions in 2017 than in the average high-income (OECD) country – a large increase from the turn of the 21st century.i A recent re-shuffle of the governance structure consolidates the purchaser role for social health insurance schemes under the newly created National Healthcare Security Administration, with most other health sector functions under the re-christened National Health Commission, among other changes. China’s world-leading technological prowess in multiple fields spanning digital commerce to artificial intelligence—and accompanying innovative business models such as WeDoctor that have not yet been fully integrated into the health system—hold promise for supporting higher quality and more convenient healthcare for China’s 1.4 billion.
Topic:
Health, Science and Technology, Governance, and Health Care Policy
Political Geography:
China and Asia

7. ACKNOWLEDGING THE FLEXIBILITIES OF THE TRIPS AGREEMENT: ENSURING THE RIGHT TO ACCESS TO MEDICINES OR A STRATEGY OF PASSIVE REVOLUTION?

Author:
Sevgi BALKAN-ŞAHİN
Publication Date:
10-2018
Content Type:
Journal Article
Journal:
Alternative Politics
Institution:
Department of International Relations, Abant Izzet Baysal University, Turkey
Abstract:
The Doha Ministerial Declaration on the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement and Public Health adopted in November 2001 clarified the right to use the TRIPS flexibilities to promote public health. Examining the hegemonic struggle of opposing social forces from a neo-Gramscian perspective, the paper attributes this outcome to the strategy of trasformismo used by market-oriented social forces to legitimize the policies of the World Trade Organization (WTO) and prevent resistance against the market-driven TRIPS Agreement. It argues that although non-governmental organizations (NGOs) such as Medecins Sans Frontieres, Third World Network, and Oxfam worked as a counter-hegemonic force to ensure the access of least developed countries to generic versions of patented drugs, flexibilities confirmed by the Doha Declaration can be seen more as a strategy of trasformismo to absorb counter-hegemonic ideas than the counter-hegemonic groups’ successful incorporation of the right to ensure public health into the TRIPS Agreement.
Topic:
Health, World Trade Organization, Hegemony, Health Care Policy, NGOs, and Public Health
Political Geography:
United States, Europe, Asia, and North America

8. Rural-Urban Disparities in the Utilization of Mental Health Inpatient Services in China: The Role of Health Insurance

Author:
Junfang Xu, Jian Wang, Madeleine King, Ruiyun Liu, Fenghua Yu, Jinshui Xing, Lei Su, and Mingshan Lu
Publication Date:
01-2018
Content Type:
Video
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
Reducing rural-urban disparities in health and health care has been a key policy goal for the Chinese government. With mental health becoming an increasingly significant public health issue in China, empirical evidence of disparities in the use of mental health services can guide steps to reduce them. We conducted this study to inform China’s on-going health-care reform through examining how health insurance might reduce rural-urban disparities in the utilization of mental health inpatient services in China.
Topic:
Health, Health Care Policy, Mental Health, Urban, and Rural
Political Geography:
China and Asia

9. Dual Practice of Public Hospital Physicians in Vietnam

Author:
Ngan Do and Young Kyung Do
Publication Date:
04-2018
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
Although many public hospital physicians in Vietnam offer private service on the side, little is known about the magnitude and nature of the phenomenon of so-called dual practice, let alone the dynamics between the public and private health sectors. This study investigates how and to what degree public hospital physicians engage in private practice. It also examines the commitment of dual practitioners to the public sector. The analysis is based on a hospital-based survey of 483 physicians at 10 public hospitals in four provinces of Vietnam. Nearly half of the participants in the study sample reported themselves as dual practitioners. Various types of private practice were mentioned. Private practice at health facilities owned by the private sector was the most prevalent, followed by private practice delivered at health facilities owned by the dual practitioners themselves. Private practice inside public hospitals was also noted. Dual practitioners were likely to be senior and hold management positions inside their public hospitals. Substantial income differences were found between dual practitioners and those physicians practicing in only the public sector. The majority of dual practitioners, however, reported the willingness to give up private practice if certain conditions were met, such as a basic salary increase or non-pecuniary benefits. The main reasons dual practitioners gave for not leaving the public sector included a sense of public responsibility and opportunities to gain a broader professional network and more training. This study reiterates the significant challenges associated with dual practice, including its financial implications and possible effects on health care quality and access. The need for a high-quality workforce committed to the public sector is particularly critical, given the possibility of universal insurance coverage. Future research should address the need to improve data collection on physicians’ dual practice and incorporate the topic in policy debates on health reform.
Topic:
Health, Health Care Policy, Reform, and Hospitals
Political Geography:
Asia and Vietnam

10. Economic Dimensions of Personalized and Precision Medicine in Asia: Evidence from Breast Cancer Treatment in Taiwan

Author:
Jui-fen Rachel Lu and Karen Eggleston
Publication Date:
04-2018
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
High costs of precision medicine raise concerns about exacerbating income-related disparities in healthcare utilization and health outcomes. One approach to expanding coverage in Asia has been to cover the precision therapy but require the pharmaceutical firm to cover the costs of the companion diagnostic test. Taiwan’s National Health Insurance (NHI) adopted this approach for lung cancer, colorectal cancer and leukemia, but not for the first target therapy covered by NHI, trastuzumab for the treatment of HER2-positive breast cancer. Analyzing a unique dataset linking medical claims, cancer registry data and proxies for income between 2004 and 2015, we find that lower-income patients are more likely to be diagnosed with later stages of breast cancer, and this pattern renders NHI coverage of anti-HER2 therapy pro-poor even before full coverage of the diagnostic tests. Moreover, the expansion of NHI coverage—including the FISH diagnostic test and trastuzumab for early-stage breast cancer—strengthened the pro-poor distribution of genetic testing and target treatment, albeit only marginally. The extent of pharmaceutical company coverage of testing and its impact on patient access are topics of our ongoing research, contrasting breast cancer with colorectal cancer.
Topic:
Health, Health Care Policy, Economic Inequality, and Medicine
Political Geography:
Taiwan and Asia