Abstract:
:In the debate on 'Third options' for health care delivery in low- and middle-income countries it is proposed that self-help should play a larger role. Self-help is expected to contribute towards improving population health outcomes and reducing government health care expenditure. We review scope and limitations of self-help groups in Europe and South Asia and assess their potential role in health care within the context of health sector reform.Self-help groups are voluntary unions of peers, formed for mutual assistance in accomplishing a health-related purpose. In Europe, self-help groups developed out of dissatisfaction with a de-personalised health care system. They successfully complement existing social and health services but cannot be instrumentalized to improve health outcomes while reducing health expenditure.In South Asia, with its hierarchical society, instrumental approaches towards self-help prevail in Non-governmental Organizations and government. The utility of this approach is limited as self-help groups are unlikely to be sustainable and effective when steered from outside. Self-help groups are typical for individualistic societies with developed health care systems - they are less suitable for hierarchical societies with unmet demand for regulated health care. We conclude that self-help groups can help to achieve some degree of synergy between health care providers and users but cannot be prescribed to partially replace government health services in low-income countries, thereby reducing health care expenditure and ensuring equity in health care.
journal_name
Int J Equity Healthjournal_title
International journal for equity in healthauthors
Nayar K,Kyobutungi C,Razum Odoi
10.1186/1475-9276-3-1keywords:
subject
Has Abstractpub_date
2004-04-15 00:00:00pages
1issue
1issn
1475-9276pii
1475-9276-3-1journal_volume
3pub_type
社论abstract:BACKGROUND:In the 2011 Rio Political Declaration on Social Determinants of Health, World Health Organization (WHO) Member States pledged action in five areas crucial for addressing health inequities. Their pledges referred to better governance for health and development, greater participation in policymaking and implem...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-018-0836-7
更新日期:2018-09-05 00:00:00
abstract:BACKGROUND:Medical specialization is a key feature of biomedicine, and is a growing, but weakly understood aspect of health systems in many low- and middle-income countries (LMICs), including India. Emergency medicine is an example of a medical specialty that has been promoted in India by several high-income country st...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-018-0824-y
更新日期:2018-09-24 00:00:00
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journal_title:International journal for equity in health
pub_type: 杂志文章,评审
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journal_title:International journal for equity in health
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更新日期:2017-11-07 00:00:00
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journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-014-0108-0
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journal_title:International journal for equity in health
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journal_title:International journal for equity in health
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journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-015-0257-9
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journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-019-0970-x
更新日期:2019-05-06 00:00:00
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journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-018-0719-y
更新日期:2018-02-05 00:00:00
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journal_title:International journal for equity in health
pub_type: 社论
doi:10.1186/1475-9276-8-27
更新日期:2009-07-30 00:00:00
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journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-016-0424-7
更新日期:2016-09-15 00:00:00
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journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-017-0575-1
更新日期:2017-06-30 00:00:00
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journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-018-0884-z
更新日期:2018-11-15 00:00:00
abstract:INTRODUCTION:Vietnam has succeeded in reducing maternal mortality in the last decades. Analysis of survey data however indicate that large inequities exist between different segments of the population. We have analyzed utilization of antenatal care and skilled birth attendance among Vietnamese women of reproductive age...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-11-24
更新日期:2012-05-15 00:00:00
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journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-017-0655-2
更新日期:2017-08-30 00:00:00
abstract:BACKGROUND:Although cervical cancer is a leading cause of cancer related morbidity and mortality among women in Ethiopia, there is lack of information regarding the perception of the community about the disease. METHODS:Focus group discussions were conducted with men, women, and community leaders in the rural settings...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-11-83
更新日期:2012-12-29 00:00:00
abstract:INTRODUCTION:The global scale-up of antiretroviral therapy (ART) for HIV patients has led to concerns regarding inequities in utilization of ART services in resource-limited contexts. In this paper, we describe regional and sex differentials in the distribution of ART among adult HIV patients in Ghana. We highlight the...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-11-62
更新日期:2012-10-16 00:00:00
abstract:BACKGROUND:Breast cancer stands as the leading cause of cancer related mortality in women worldwide. Mammography screening has the potential to improve prognosis by reducing stage at diagnosis. Socioeconomic inequalities in mammography cancer screening have been widely reported. The influence of organised programs on s...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-018-0811-3
更新日期:2018-07-03 00:00:00
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journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-019-1102-3
更新日期:2019-12-31 00:00:00
abstract:BACKGROUND:The concept of social capital has been extensively used to explain the relationship between socioeconomic status (SES) and adolescent health and well-being. Much less is known about the specific mechanism through which social capital impacts the relationship. This paper investigates whether an individual's p...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-016-0490-x
更新日期:2016-12-12 00:00:00
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journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-018-0865-2
更新日期:2018-09-24 00:00:00
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journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-018-0875-0
更新日期:2018-11-08 00:00:00
abstract:BACKGROUND:Health equity is a priority in the global sustainable development agenda. Available health equity indicators often focus on health outcomes, access to healthcare, risk factors and determinants such as income, education, and gender. Less attention has been given to other social determinants, including those r...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-019-0978-2
更新日期:2019-06-03 00:00:00
abstract::The unifying theme of the papers in this series is a concern for understanding the everyday practice of governance in low- and middle-income country (LMIC) health systems. Rather than seeing governance as a normative health system goal addressed through the architecture and design of accountability and regulatory fram...
journal_title:International journal for equity in health
pub_type: 社论
doi:10.1186/s12939-017-0665-0
更新日期:2017-09-15 00:00:00
abstract:CONTEXT:The Kenya Partnership for Health (KPH) program began in 1999, and is currently one of the 12 field projects participating in the WHO's 'Towards Unity for Health initiative' implemented to develop partnership synergies in support of the Primary Health Care (PHC) approach 1. CONTENT:This paper illustrates how Pr...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-4-8
更新日期:2005-06-24 00:00:00
abstract:BACKGROUND:Aggregate urban health statistics mask inequalities. We described maternity care in vulnerable slum communities in Mumbai, and examined differences in care and outcomes between more and less deprived groups. METHODS:We collected information through a birth surveillance system covering a population of over 2...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-8-21
更新日期:2009-06-05 00:00:00
abstract:BACKGROUND:Aboriginal and Torres Strait Islander women experience higher rates of obesity, chronic disease, and are less active than non-Indigenous Australian women. Lifestyle programs designed to increase physical activity and encourage healthy eating are needed to ameliorate this disparity. The aim of this study was ...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-12-11
更新日期:2013-01-24 00:00:00
abstract:BACKGROUND:Like most Central European countries Slovakia has experienced a period of socioeconomic changes and at the same time a decline in the mortality rate. Therefore, the aim is to study socioeconomic factors that changed over time and simultaneously contributed to regional differences in mortality. METHODS:The a...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-016-0404-y
更新日期:2016-07-19 00:00:00
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journal_title:International journal for equity in health
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12939-017-0643-6
更新日期:2017-08-30 00:00:00