Health System in Developing Countries for Practice - myassignmenthelp

Question: Discuss about theHealth System in Developing Countries for Dual Practice. Answer: Introduction Health system is a collection of institutions, group of people and accumulation of supplies that can be used to meet the health needs of the target group. Decentralization is the distribution of people, things, and power in different locations. According to the proposal, the health system is in the process of being distributed to different districts in developing countries. Decentralization comes up with several benefits and challenges which organization should come up with a solution to solving. Kenya is among developing countries that has encouraged decentralization of health sector. Health services have been distributed to different counties. Private health institutions have increased at a high rate. Most of Kenyan citizens use private hospitals because they offer quality services compared to public sector. Kenya has come up with rules that govern the operation of both private and public health institutions. The rules help in offering quality services to the patients. Public health institutions in Kenya offer low quality services because of low pay they receive. Also, public health workers are not given incentives to encourage them to offer quality services. Public sector in Kenya is facing a lot of negative impacts and most people prefer using the private sector. Benefits of Decentralization Decentralization helps in distribution of resources to different areas. Also, it assists in the fair and equitable distribution of health services in different locations. People who were unable to receive government health services are able to access. Local people participating in government health services will assist in communicating with the people involved on what they need the government to supply to them. Health services decentralization will also help in creating more jobs to the unemployed health worker (Cobos et al., 2017). Below is the discussion the challenge of decentralization in an area where health workers engaged in both private and public health services and the solution. Impacts of Dual Practice at District Dual practice is the idea of operating both private and public hospital by health workers. There is an increase in the percentage of the number of private health units in the low-income countries. The private sector includes non-government organization, individual doctors, nurses and midwives and unqualified individuals who sell medicines on market stalls. The increase in the private sector has increased due to increase in the number of qualified staff, failure of the public sector to meet the expectations and low payment of the staff in public sector. The increase in the private health sector has led to the idea of enabling of access to the services, shortages, and distribution of the resources. Also, individuals argue on the need to increase the supply of drugs. Public health workers have two sources of income due to low pay. Workers in public health institutions are not provided with incentives for good performance. Lack of incentives leads to them providing low quality of services and having an uncaring and unresponsive attitude towards their patients. The public health workers open a private hospital and continue to work in the public sector. In addition, the public resources are distributed unfairly. The middle-class people are the one who benefits from the resources distributed to the health institutions. Private health institutions operate with the main aim of getting profits as opposed to public health institutions. Patients lack of knowledge leads to patients receiving low-quality treatment at private health services at high prices. Governments in developing countries are turning their resources to the private health institutions with the idea of making profits (Abimbola et al., 2014). Therefore, the government fails to provide enough resources to the public health institutions and thus many patients are experiencing difficulties in finances to get quality health service. The poor in the low-income countries are forced by the situation to visit private health institutions for treatment. Moreover, other challenges faced by low-income countries are lack of finances, poor infrastructure and service delivery. The government has not improved the roads and systems of communications in the interior, and this leads to facing problems in operation of public health institutions in district level (Coarasa et al., 2017). However, it is simple for the private health institutions to operate from the interior because all their employees and information needed will be given by an individual in the place. The public sector has few qualified individuals, and those individuals operate on an hourly system. Therefore, the qualified medical workers open their own hospitals to add on their income. This leads to qualified staff dedicating most of their time in their clinics. In addition, they influence their patients to tranfer to their private clinics so that they may have quality treatment. This happens mainly because of poor payment of health workers. The private sector has a wide variety of qualified individuals. Patients are faced with the challenge of choosing the best health services to take. The confusion may lead to patient choosing the wrong medical services because they have very little information about health service. Also, private individuals are answerable to any services and outcomes, financial rewards and penalties and this leads to them been careful on delivering their services as opposed to when they are delivering the same service in the public sector. In the public sector there is no one to be answerable to, and therefore they will neglect their work and focus on the private investment they have. Moreover, decentralization of health services faces mismanagement of funds. Mismanagement of funds is caused by the top officials directing some of the allocated resources to their private institutions (Dutton, 2012). The top-level managers have no one to answer to in the district, and therefore they will allocate some of the government resources to their private hospital. In addition, there will be few qualified staffs to plan on the usage of the resources and this lead to poor planning. Also, the manipulation by the government officials at the district level leads to poor planning. Officials at the district level are corrupt and focus on how to improve their private health institution at no expense. Private Sector is Better Equipped The private sector has introduced technology in their operations. This has led to public sector losing patients to the private sector. There are two technologies used in health. The two technologies are e-health and m- health. E-health is the use of intergraded computer technologies while m- health is the use of mobile technology in delivering services. With the increased use of technologies in low-income countries people prefer to use technology in health services. However, the public sector has not acknowledged the use of technology, and it may be challenging to decentralize health services to district level using the traditional means. Addressing the Problem of Decentralization Solutions to the challenges faced due to the health workers engaging in dual practice include, the government should increase the payment they offer to public health workers. Increasing of payment will lead to encouragement of workers to perform their duties well. Health workers receiving good payment will not need a double income and thus will concentrate on delivering quality service in the public sector. In addition, public health workers should be given incentives according to their performance. Incentives will give motivation for offering quality service. The health workers will offer services of high quality with the interest of getting an incentive. In addition, with the help of government on training shopkeepers on ways of prescribing drugs, it will lead to quality delivery. Moreover, patients should be educated on the way to know quality medical services. This will help patients to receive quality services and discourage operation of health services with the interest of making more profits. Also, the government should offer subsidies to the public sector to reduce the cost of operation. Reduction in the cost of operation will lead to low prices in the public sector and also an improvement on the quality of services offered. Poor patients will be able to get health services at an affordable price (Mills, 2014). Also, health workers should be supervised to distribute the resources they have equally and fairly to both middle and low class. The public health sector should have someone who the health workers will be answerable to in case of misconduct. The government may enter into a contract with donors and non-government organization to assist with the finances and building of infrastructure to enable decentralization of health services into different districts. Also, the government may create a monopoly in the operation of health services to the public sector. The monopoly of the public sector will assist in making the health workers concentrate in only the public sector. The health workers will dedicate all their time to the public sector because they will not have any other job to run. In addition, the private sector may merge with public sector and provide services without facing any competition from each other. Merging will assist in sharing of expertise in different departments. The government should ensure the top officials are accountable to how the resources allocated to them are been used. They should also create a position for a person who will be supervising on the usage of the resources allocated to the district. The government should also increase the number of qualified staff in the planning department of the allocation of resources. Enough qualified staff will lead to proper allocation of resources. Top officials should be prohibited from owning private health hospital. They should also be monitored not to supply the allocated resources to other places. Corrupt district officials should be prohibited from participating in public health institutions activities. Public health sector may also introduce e-health and m- health to fasten the distribution of health sectors in different districts (Lewis et al., 2012). Also, use of technology is encouraged because most of the people in low-income countries are using technology to access different services. Technology gadgets have reduced prices because most of the people are using and therefore anybody can afford the gadgets. The use of technology will assist in minimizing the challenge of distribution of resources fairly and equally. The government may also introduce classes on technology for the people who have not yet learned technology. Moreover, use of governance may assist in the management of health sector (Wickremasinghe et al., 2016). The management of health workers should come up with rules and code of conduct. The rules will direct the health workers on the management of resources supplied by the government and the operation of the health institutions. The laws should include the operation of private health services. With the help of rules, there will be no unhealthy relationship between private and public sector. Also, it will help in evaluation and understanding of health sector. Governance will also help in creating a good relationship between donors, non-government organization with the health sectors. The government in low-income countries may fail to concentrate on the operation of the health sector but with the help of rules corruption in the health sector will be reduced. Evaluation After implementation of the health system in district level they will be need of evaluation to ensure it is not affected by the challenge. The process of evaluation will require annual reviews, statistical report and program report and performance assessment. The performance evaluation will be achieved by surveying the community in the area. With the reports obtained from the survey and statistical and program, health institution will be able to check whether it is affected by the challenges. The annual review will assist in determining any changes that might occur in the specific year evaluated. Conclusion To conclude, health sector decentralization faces several challenges. One of the challenges is health workers involved in dual practice. The dual practice will lead to the conflict of interest between the private and public health sector. However, it may also lead to positive impacts regarding distribution of the service and reduction in shortages of medicines. Some of the reasons causing the dual practice are low payment and lack of incentives. Therefore, with an increase in payment and offering of incentives by the government, it will reduce the dual practice. Also, increase in working hours of the health workers will reduce dual workers. The government should also work on improving infrastructure, services delivery and the introduction of subsidies. Also, use of technology will strengthen the health sector. References Abimbola, S., Abimbola, S., Negin, J., Jan, S., Martiniuk, A., Abimbola, S., Jan, S., ... Martiniuk, A. (January 01, 2014). Towards people-centred health systems: A multi-level framework for analysing primary health care governance in low-and middle-income countries. Health Policy and Planning, 29. Bitton, A., Gummerson, E., Das, J., Coarasa, J. (April 12, 2017). A systematic tale of two differing reviews: evaluating the evidence on public and private sector quality of primary care in low and middle income countries. 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