Private health care providers play an increasingly important role in the health systems of many low-income and middle-income countries, easing some of the pressure on governments to provide health care services for all citizens and helping them to overcome funding constraints. The need to regulate the activities of the private sector has become increasingly apparent. However, many countries have little experience of regulation, and in low-income countries the priority of health ministries is to deliver basic health care, rather than implementing what are often "imported" regulatory frameworks.

Recent changes to the health service including new structures and ways of working at both local and national levels are having major influences on the working lives of every health visitor and community nurse and on their professional opportunities. Understanding these changes is essential and this practical and authoritative handbook addresses them all. The authors all have first-hand experience of the radical changes underway. The clear straightforward format is designed to allow quick access to relevant and up-to-date information. The book is vital reading for every community practitioner.

"This volume examines the public/private sector mix in a number of national healthcare systems and their interface with the goals of health equity and quality of healthcare. Moreover, there is a consideration of public accountability. The unique significance of this collection of national studies involving the public/private sector mix of healthcare services and/or finances is that it provides insights into the factors that enhance the public/private sector mix in fulfilling the goals of health equity and the quality of healthcare services as well as an understanding of the circumstances in which elements of the public/private sector mix may be harmful for the achievement of such goals in a variety of national settings. The contributions to this volume provide a variety of perspectives in dealing with these objectives"--

Private financing of care can make universal entitlement to care more comprehensive' and complete.' The possible combination -- at the point of service provision -- of privately acquired entitlement with the public entitlement, can impinge, however, upon the goals (e.g. improved health, equity, cost containment, care production efficiency, and client satisfaction from service) of the publicly supported health system. The potential to achieve these goals is at greatest risk in the combined system' (e.g., Australia) where, contrary to the segregated system' (e.g., Canada), the same providers are sanctioned to provide medical care under both private and public contracts. A combined system may be inevitable, however, for both economic and political reasons, especially where medical resources are relatively scarce. In this case, the Emerging Paradigm in health systems can offer the best possible solution to the public-private mix issue. In this paradigm, budget-holding institutions, intermediaries between financing entities and providers, organize and manage the consumption of care (OMCC) under public entitlement. The OMCC institutions can offer private insurance, to supplement to the public insurance', but supervise separate groups of providers, those working under public contracts and those working under private

The public health systems of the Nordic countries were established to provide care equitably to those in need, not to provide responsive consumer services. These systems are now at a crossroads. This report draws attention to the changes in and expansion of the private sector. It presents facts about financing and provision, and an analysis of the changes, their causes and consequences. The report concludes that Nordic citizens and governments need the private health sector, for a variety of reasons.

Exploring the increasing involvement of the private sector in social policy, this collection examines the complex relationship between the public and private sectors from an international perspective, focusing on health and pension policies.

This title provides a systematic and accessible introduction to medical sociology, beginning each 1500 word entry with a definition of the concept, then examines its origins, development, strengths and weaknesses, offering further reading guidance for independent learning, and drawing on international literature and examples.

Health planning is a critical component when responding to the health needs of low and middle income countries, characterised by particularly stringent resource constraints. The major communicable diseases such as AIDS, TB and malaria often appear in parallel with growing non-communicable diseases including heart disease and diabetes, and yet resources are often less than the levels recommended by the World Health Organisation for basic health care.The new edition of this well-respected text explains the importance of health planning in both developing regions such as Africa, and those in transition, such as Central and Eastern Europe. It stresses the importance of understanding the national and international context in which planning occurs, and provides an up to date analysis of the major current policy issues, including health reforms. Separate chapters are dedicated to the distinct issues of finance for health care and humanresource planning. The various techniques used at each stage of the planning process are explained, starting with the situational analysis and then looking in turn at priority-setting, option appraisal, programming, implementation, monitoring, and evaluation. The book ends by examining the challengesfacing planners in the 21st century, particularly in the light of growing globalisation. A major theme of the book is the need to recognise and reconcile the inevitable tension that lies between value judgements and 'rational' decision-making. As such, in addition to introducing techniques such as costing and economic appraisal, it also outlines techniques such as stakeholder analysis for understanding the relative attitudes and power of different groups in planning decisions.Each chapter includes a comprehensive bibliography (including key websites), a summary, and exercises to help the reader practise techniques and better understand the content. The book argues that all health professionals and community groups should be involved in the planning process for it to be effective, and will therefore appeal to anyone involved in planning.

Until the start of the new century, efforts to strengthen health systems focused solely on the public sector and health programs overseen by public bodies. The private sector was sidelined in certain countries and even banned in others. At the same time, some private-sector stakeholders readily adapted themselves to this special situation so as to avoid becoming part of a structured health system.This volume notes profound changes in health care around the world in two areas. The stakeholders involved in the health sector are increasing in number and diversifying as a result of the development of the private sector. They are also responding to a process of democratization and decentralization. These developments have been paralleled by greater functional differentiation. Various stakeholders are increasingly specializing in particular areas of the health system: service delivery, procurement, management, financing, and regulation.The interdependence of health stakeholders becomes more evident along with the increased complexity of delivery systems as these respond to changing demand. There is a compelling need to forge relationships. Such relationships are in fact emerging in developed countries and, more recently, in developing countries. They may be informal, but are increasingly organized and structured.