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The Global Health System: Strengthening National Health Systems as the Next Step for Global Progress
Julio Frenk
PLOS Medicine , 2010, DOI: 10.1371/journal.pmed.1000089
Abstract:
Tender puentes: lecciones globales desde México sobre políticas de salud basadas en evidencias
Frenk,Julio;
Salud Pública de México , 2007, DOI: 10.1590/S0036-36342007000700006
Abstract: during the past six years, mexico has undergone a large-scale transformation of its health system. this paper provides an overview of the main features of the mexican reform experience. because of its high degree of social inequality, mexico is a microcosm of the range of problems that affect countries at all levels of development. its health system had not kept up with the pressures of the double burden of disease, whereby malnutrition, common infections, and reproductive health problems coexist with non-communicable disease and injury. with half of its population uninsured, mexico was facing an unacceptable paradox: whereas health is a key factor in the fight against poverty, a large number of families became impoverished by expenditures in health care and drugs. the reform was designed to correct this paradox by introducing a new scheme called popular health insurance (seguro popular). this innovative initiative is gradually protecting the 50 million mexicans, most of them poor, who had until now been excluded from formal social insurance. this paper reports encouraging results in the achievement of the ultimate objective of the reform: universal access to high-quality services with social protection for all.
Transiciones: vidas, instituciones, ideas
FRENK JULIO
Salud Pública de México , 1997,
Abstract:
Avedis Donabedian
Frenk Julio
Salud Pública de México , 2000,
Abstract:
Avedis Donabedian
Frenk Julio
Bulletin of the World Health Organization , 2000,
Abstract:
Overcoming gaps to advance global health equity: a symposium on new directions for research
Julio Frenk, Lincoln Chen
Health Research Policy and Systems , 2011, DOI: 10.1186/1478-4505-9-11
Abstract: Twenty years ago, an independent international initiative, the Commission on Health Research for Development, issued its landmark report, Health Research: Essential Link to Equity in Development [1], on how to "accelerate health improvements and overcome health disparities worldwide." At that time, the landscape of global health was strikingly different. There were fewer actors and severely-limited resources. The reigning paradigm was paternalistic and unidirectional: solutions were exported from the north to the south, while problems flowed from the south to be solved by the north. This seminal Report broke boldly through the crippling and rigid mindset by recommending that every country, no matter how rich or poor, should acquire key core research capability--"essential national health research" - to tackle priority national problems. Recognizing the interdependence of nations and of knowledge, the Report also underscored the value of global partnerships for health research to address commonly shared challenges.The past 20 years have witnessed remarkable growth in the realization of the importance of global health; new avenues in global health research have opened; and research capacity in developing countries has been enhanced. In just the past decade, development assistance in health increased from US$10.7 billion in 2000 to US$21.8 billion in 2007 [2], although the fiscal impact of the recent financial crisis has yet to be registered. There are now more than 100 multilateral partnerships, agencies and initiatives in global health.The 20th anniversary of the report provided an occasion to review progress and re-launch a movement around research as a crucial ingredient for the renewal of global health cooperation. More than 200 panelists and participants from around the world convened in Boston at a Symposium hosted by the Harvard School of Public Health on May 13, 2010, to grapple with "New Directions for Global Health Research." The discussion focused on the Co
Editorial
Mora Julio Frenk
Salud Pública de México , 2002,
Abstract:
Health and the economy: empowerment through evidence
Frenk Julio,Knaul Felicia
Bulletin of the World Health Organization , 2002,
Abstract:
The New Harvard Doctor of Public Health: Lessons From the Design and Implementation of an Innovative Program in Advanced Professional Leadership
Julio Frenk,Peter Berman
- , 2018, DOI: 10.1177/0033354918804523
Abstract: We documented lessons learned in the initial design and development of the new Harvard doctor of public health (DrPH) degree, an innovative professional public health doctorate designed to provide advanced education in the field of public health. Using data from program documents, personal participation in the development and administration of the degree, and initial students’ results, we present key learnings from this experience and describe the program’s goals and processes. Now entering its fifth year, the new Harvard DrPH program has enrolled about 70 students and graduated its first 2 classes in a program that combines advanced public health study with leadership development and field engagement. Development of this transformational innovation in advanced public health education required creative approaches to competency development and curriculum design, engagement of faculty to become supportive stakeholders, and substantial support for educational administration. Demand for a program of this type is strong. Continuous improvement is ongoing
A framework for assessing the performance of health systems
Murray,Christopher J.L.; Frenk,Julio;
Bulletin of the World Health Organization , 2000, DOI: 10.1590/S0042-96862000000600004
Abstract: health systems vary widely in performance, and countries with similar levels of income, education and health expenditure differ in their ability to attain key health goals. this paper proposes a framework to advance the understanding of health system performance. a first step is to define the boundaries of the health system, based on the concept of health action. health action is defined as any set of activities whose primary intent is to improve or maintain health. within these boundaries, the concept of performance is centred around three fundamental goals: improving health, enhancing responsiveness to the expectations of the population, and assuring fairness of financial contribution. improving health means both increasing the average health status and reducing health inequalities. responsiveness includes two major components: (a) respect for persons (including dignity, confidentiality and autonomy of individuals and families to decide about their own health); and (b) client orientation (including prompt attention, access to social support networks during care, quality of basic amenities and choice of provider). fairness of financial contribution means that every household pays a fair share of the total health bill for a country (which may mean that very poor households pay nothing at all). this implies that everyone is protected from financial risks due to health care. the measurement of performance relates goal attainment to the resources available. variation in performance is a function of the way in which the health system organizes four key functions: stewardship (a broader concept than regulation); financing (including revenue collection, fund pooling and purchasing); service provision (for personal and non-personal health services); and resource generation (including personnel, facilities and knowledge). by investigating these four functions and how they combine, it is possible not only to understand the proximate determinants of health system performance,
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