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Health systems

Section Editor: Mihajlo Jakovljevic, University of Kragujevac, Serbia
Deputy Section Editors: 
Fiona Cianci, Health Service Executive, Dublin, Ireland, 
Meri Koivusalo, Tampere University, Finland
Daniel Maceira, Center for the Study of State and Society, Argentina,
Elena Potapchik, Higher School of Economics, Russia ​​​​​​​

At a global level, international institutions, donors, grants and conditional loans are increasingly influencing the financing and organization of health systems in much of the world, with implications for equity in access to care. There is a renewed global push for universal health coverage but lack of agreement on how it should be funded or administered. Private financing for health systems in many countries is rising; there is a critical shortage of human resources for health; out-of-pocket payments continue to push people into ‘medical poverty’; and the high costs of new medical technologies or therapeutics too often available only to the few challenge appropriate funding levels for comprehensive primary health services essential to the many. Papers submitted under this topic explore how globalization-related processes are affecting the development of national and regional health systems, with a focus on how such systems improve health equity in terms of access, coverage, and financing. Note: We are not accepting articles on health systems that do not attend to how they are being affected by globalization.

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  1. Most international electives in which medical students from high-income countries travel abroad are largely unstructured, and can lead to problematic outcomes for students as well as sending and receiving inst...

    Authors: Chris Willott, Eva Khair, Roger Worthington, Katy Daniels and A. Mark Clarfield

    Citation: Globalization and Health 2019 15:84

    Content type: Review

    Published on:

  2. The interconnections between health and the economy are well known and well documented. The funding gap for realizing SDG3 for good health and well-being, however, remains vast. Simultaneously, economic growth...

    Authors: Mariska Meurs, Lisa Seidelmann and Myria Koutsoumpa

    Citation: Globalization and Health 2019 15:83

    Content type: Research

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  3. In conflict settings, research capacities have often been de-prioritized as resources are diverted to emergency needs, such as addressing elevated morbidity, mortality and health system challenges directly and...

    Authors: Nassim El Achi, Andreas Papamichail, Anthony Rizk, Helen Lindsay, Marilyne Menassa, Rima A. Abdul-Khalek, Abdulkarim Ekzayez, Omar Dewachi and Preeti Patel

    Citation: Globalization and Health 2019 15:81

    Content type: Research

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  4. There is a current need to build the capacity of Health Policy and Systems Research + Analysis (HPSR+A) in low and middle-income countries (LMICs) as this enhances the processes of decision-making at all level...

    Authors: Obinna Onwujekwe, Enyi Etiaba, Chinyere Mbachu, Uchenna Ezenwaka, Ifeanyi Chikezie, Ifeyinwa Arize, Chikezie Nwankwor and Benjamin Uzochukwu

    Citation: Globalization and Health 2019 15:69

    Content type: Research

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  5. The aim of this study was to examine the determinants of nutritional status among children under age 5 (0–59 months) in Ethiopia. Child malnutrition is an underlying cause of almost half (45%) of child deaths,...

    Authors: Zerihun Yohannes Amare, Mossa Endris Ahmed and Adey Belete Mehari

    Citation: Globalization and Health 2019 15:62

    Content type: Research

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  6. Globalization has made it possible for global health professionals and trainees to participate in short-term training and professional experiences in a variety of clinical- and non-clinical activities across b...

    Authors: Ashti Doobay-Persaud, Jessica Evert, Matthew DeCamp, Charlesnika T. Evans, Kathryn H. Jacobsen, Natalie E. Sheneman, Joshua L. Goldstein and Brett D. Nelson

    Citation: Globalization and Health 2019 15:60

    Content type: Research

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  7. Health security in the European Union (EU) aims to protect citizens from serious threats to health such as biological agents and infectious disease outbreaks- whether natural, intentional or accidental. Threat...

    Authors: Máirín Boland and Mary O’Riordan

    Citation: Globalization and Health 2019 15:53

    Content type: Review

    Published on:

  8. Health challenges and health systems set-ups differ, warranting contextualised healthcare interventions to move towards universal health coverage. As such, there is emphasis on generation of contextualized evi...

    Authors: Simbarashe Rusakaniko, Michael Makanga, Martin O. Ota, Moses Bockarie, Geoffrey Banda, Joseph Okeibunor, Francisca Mutapi, Prosper Tumusiime, Thomas Nyirenda, Joses Muthuri Kirigia and Juliet Nabyonga-Orem

    Citation: Globalization and Health 2019 15:50

    Content type: Research

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  9. Although various organizations working in developed countries established the standards and approaches used in occupational hygiene, occupational hygiene professional interests and needs continue to develop in...

    Authors: Sibel Kiran, Alp Ergor, Ceyda Sahan, Esra Emerce, Sergio Luzzi and Yucel Demiral

    Citation: Globalization and Health 2019 15:39

    Content type: Research

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  10. In Uganda, more than 336 out of every 100,000 women die annually during childbirth. Pregnant women, particularly in rural areas, often lack the financial resources and means to access health facilities in a ti...

    Authors: Ligia Paina, Gertrude Namazzi, Moses Tetui, Chrispus Mayora, Rornald Muhumuza Kananura, Suzanne N. Kiwanuka, Peter Waiswa, Aloysius Mutebi and Elizabeth Ekirapa-Kiracho

    Citation: Globalization and Health 2019 15:38

    Content type: Short report

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  11. For many countries, including Malawi, Tanzania and Zimbabwe, 2017 was a transition year for support from the Global Fund to Fight AIDS, Tuberculosis and Malaria as one funding cycle closed and another would be...

    Authors: Russell Armstrong, Arlette Campbell White, Patrick Chinyamuchiko, Steven Chizimbi, Sarah Hamm Rush and Nana K. Poku

    Citation: Globalization and Health 2019 15:34

    Content type: Research

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  12. Global Engagement works with health partnerships to establish workforce and educational translation on a global scale to support the National Health Service (NHS). There is growing evidence on how internationa...

    Authors: B. Zamora, M. Gurupira, M. Rodes Sanchez, Y. Feng, K. Hernandez-Villafuerte, J. Brown and K. Shah

    Citation: Globalization and Health 2019 15:31

    Content type: Research

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  13. The nutritional traffic light label (NTLL) has become one of the most used Front of Package labels (FOP’s) around the world, for its simple and easy to understand graphical system. In Ecuador, this labelling s...

    Authors: Santiago Teran, Isabel Hernandez, Wilma Freire, Beatriz Leon and Enrique Teran

    Citation: Globalization and Health 2019 15:26

    Content type: Research

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  14. Ethiopia has been implementing a community health extension program (HEP) since 2003. We aimed to assess the successes and challenges of the HEP over time, and develop a framework that may assist the implement...

    Authors: Yibeltal Assefa, Yalemzewod Assefa Gelaw, Peter S. Hill, Belaynew Wassie Taye and Wim Van Damme

    Citation: Globalization and Health 2019 15:24

    Content type: Research

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  15. Conducting health research in conflict-affected areas and other complex environments is difficult, yet vital. However, the capacity to undertake such research is often limited and with little translation into ...

    Authors: Gemma Bowsher, Andreas Papamichail, Nassim El Achi, Abdulkarim Ekzayez, Bayard Roberts, Richard Sullivan and Preeti Patel

    Citation: Globalization and Health 2019 15:23

    Content type: Review

    Published on:

  16. Recent developments in connected health technology provide an opportunity to remotely monitor and provide health care to the patient needing long-term medical care. However, information about how any connected...

    Authors: Abdullah M. Aldahmash, Zakiuddin Ahmed, Fatima R. Qadri, Subash Thapa and Abdulrahman Mohammed AlMuammar

    Citation: Globalization and Health 2019 15:20

    Content type: Debate

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  17. The objective of this article is to describe the state of North, Central, South American and Caribbean (Pan-American) indigenous health. The second objective is to identify recommendations for optimal healthca...

    Authors: Julie Babyar

    Citation: Globalization and Health 2019 15:16

    Content type: Review

    Published on:

  18. Globally, health service leaders and managers have a critical role in strengthening health systems. Competency frameworks for health service managers are usually designed to describe expectations of good perfo...

    Authors: Reema Harrison, Lois Meyer, Ashfaq Chauhan and Maria Agaliotis

    Citation: Globalization and Health 2019 15:11

    Content type: Research

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  19. This article describes a twinning relationship between the Canadian Association of Midwives (CAM) and the Tanzania Midwives Association (TAMA). It argues that the twinning relationship strengthened both associ...

    Authors: Rachel Sandwell, Deborah Bonser, Emmanuelle Hebert, Katrina Kilroy, Sebalda Leshabari, Feddy Mwanga, Agnes Mtawa, Anne Wilson and Amelie Moritz

    Citation: Globalization and Health 2018 14:123

    Content type: Commentary

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  20. Healthcare systems are increasingly recognised as complex, in which a range of non-linear and emergent behaviours occur. China’s healthcare system is no exception. The hugeness of China, and the variation in c...

    Authors: Yue Xiao, Lewis Husain and Gerald Bloom

    Citation: Globalization and Health 2018 14:112

    Content type: Review

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  21. National pharmacovigilance centres (national centres) are gradually gaining visibility as part of the healthcare delivery system in Africa. As does happen in high-income countries, it is assumed that national ...

    Authors: H. Hilda Ampadu, Jarno Hoekman, Daniel Arhinful, Marilyn Amoama-Dapaah, Hubert G. M. Leufkens and Alex N. O. Dodoo

    Citation: Globalization and Health 2018 14:109

    Content type: Research

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  22. The 9th Global conference on health promotion (Shanghai 2016) reaffirmed the role of primary health care (PHC) in achieving the 2030 Sustainable Development Agenda. Gaining much international recognition, the ...

    Authors: Abraham Assan, Amirhossein Takian, Moses Aikins and Ali Akbarisari

    Citation: Globalization and Health 2018 14:107

    Content type: Research

    Published on:

  23. United Nations Children’s Fund (UNICEF) designed EQUitable Impact Sensitive Tool (EQUIST) to enable global health community address the issue of equity in maternal, newborn and child health (MNCH) and minimize he...

    Authors: Chigozie Jesse Uneke, Issiaka Sombie, Henry Chukwuemeka Uro-Chukwu and Ermel Johnson

    Citation: Globalization and Health 2018 14:104

    Content type: Research

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  24. Healthcare challenges in low and middle income countries (LMICs) have been the focus of many digital initiatives that have aimed to improve both access to healthcare and the quality of healthcare delivery. Mov...

    Authors: Alain B. Labrique, Christina Wadhwani, Koku Awoonor Williams, Peter Lamptey, Cees Hesp, Rowena Luk and Ann Aerts

    Citation: Globalization and Health 2018 14:103

    Content type: Review

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  25. Access to quality-assured medical products improves health and save lives. However, one third of the world’s population lacks timely access to quality-assured medicines while estimates indicate that at least 1...

    Authors: Lukas Roth, Daniel Bempong, Joseph B. Babigumira, Shabir Banoo, Emer Cooke, David Jeffreys, Lombe Kasonde, Hubert G. M. Leufkens, John C. W. Lim, Murray Lumpkin, Gugu Mahlangu, Rosanna W. Peeling, Helen Rees, Margareth Ndomondo-Sigonda, Andy Stergachis, Mike Ward…

    Citation: Globalization and Health 2018 14:102

    Content type: Review

    Published on:

  26. As performance-based financing (PBF) has been increasingly implemented in low-income countries, a growing literature has developed, assessing its effectiveness and, more recently, focussing on the political dy...

    Authors: Maria Paola Bertone, Haja Wurie, Mohamed Samai and Sophie Witter

    Citation: Globalization and Health 2018 14:99

    Content type: Research

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  27. Skilled health professionals are a critical component of the effective delivery of lifesaving health interventions. The inadequate number of skilled health professionals in many low- and middle-income countrie...

    Authors: Angela E Micah, Bianca S Zlavog, Catherine S Chen, Abigail Chapin and Joseph L Dieleman

    Citation: Globalization and Health 2018 14:98

    Content type: Research

    Published on:

  28. The Salud Mesoamérica Initiative is a public-private partnership aimed at reducing maternal and child morbidity and mortality for the poorest populations in Central America and the southernmost state of Mexico...

    Authors: Charbel El Bcheraoui, Aruna M Kamath, Emily Dansereau, Erin B Palmisano, Alexandra Schaefer, Bernardo Hernandez and Ali H Mokdad

    Citation: Globalization and Health 2018 14:97

    Content type: Research

    Published on:

  29. Rehabilitation is crucial for the realization of the right to health and a proper concern of global health. Yet, reliable information to guide rehabilitation service planning is unavailable in many countries i...

    Authors: Dimitrios Skempes, John Melvin, Per von Groote, Gerold Stucki and Jerome Bickenbach

    Citation: Globalization and Health 2018 14:96

    Content type: Research

    Published on:

  30. Global health policy prioritizes improving the health of women and girls, as evident in the Sustainable Development Goals (SDGs), multiple women’s health initiatives, and the billions of dollars spent by inter...

    Authors: Valerie Percival, Esther Dusabe-Richards, Haja Wurie, Justine Namakula, Sarah Ssali and Sally Theobald

    Citation: Globalization and Health 2018 14:90

    Content type: Review

    Published on:

  31. Despite more than 20 years of reform projects in health systems, the universal coverage strategy has not reached the expected results in most middle-income countries (MICs). Using evidence from the Mexican cas...

    Authors: Armando Arredondo, Alejandra Azar and Ana Lucia Recaman

    Citation: Globalization and Health 2018 14:89

    Content type: Debate

    Published on:

  32. The objective was to guide key stakeholders on future directions of external funding of international postgraduate training (Master’s and PhD) of health research students at institutions in sub-Saharan Africa ...

    Authors: Terra Morel, Dermot Maher, Thomas Nyirenda and Ole F. Olesen

    Citation: Globalization and Health 2018 14:77

    Content type: Research

    Published on:

  33. Cancer is a major burden of disease in low- and middle-income countries (LMICs) yet financial barriers limit access to life-saving oncology drugs. Medical donation and other drug access programs can help impro...

    Authors: Ann Kim Novakowski, Pat Garcia-Gonzalez, Michael Wrigglesworth and Andy Stergachis

    Citation: Globalization and Health 2018 14:76

    Content type: Research

    Published on:

  34. In the literature, measuring health outcomes usually entails examining one dependent variable using cross-sectional data. Using a combination of mortality and morbidity variables, this study developed a new, r...

    Authors: Rezwanul Hasan Rana, Khorshed Alam and Jeff Gow

    Citation: Globalization and Health 2018 14:72

    Content type: Research

    Published on:

  35. The provision of high-quality medical care to asylum seekers represents a key challenge in many countries of the European Union. Especially continuity of care has been difficult to achieve as the migrant traje...

    Authors: Rosa Jahn, Sandra Ziegler, Stefan Nöst, Sandra Claudia Gewalt, Cornelia Straßner and Kayvan Bozorgmehr

    Citation: Globalization and Health 2018 14:71

    Content type: Research

    Published on:

  36. The importance of leadership development in the early stages of careers in the NHS has been highlighted in recent years and many programmes have been implemented which seek to develop leadership skills in heal...

    Authors: Alexandra Monkhouse, Leanne Sadler, Andrew Boyd and Fleur Kitsell

    Citation: Globalization and Health 2018 14:69

    Content type: Research

    Published on:

  37. With globalization, more and more people travel to countries where they are at risk of injuries and travel-related diseases. To protect travelers’ health, it is crucial to understand whether travelers accurate...

    Authors: Yi-Hsuan Lee, Chia-Wen Lu, Pei-Zu Wu, Hsien-Liang Huang, Yi-Chun Wu and Kuo-Chin Huang

    Citation: Globalization and Health 2018 14:67

    Content type: Research

    Published on:

  38. Global spending for HIV prevention has been decreasing over the years. As a result, several low-income countries, including Nepal, are increasingly facing the challenge to minimize the funding gap to continue ...

    Authors: Subash Thapa and Arja R. Aro

    Citation: Globalization and Health 2018 14:64

    Content type: Debate

    Published on:

  39. Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the populatio...

    Authors: Anna D. Gage, Hannah H. Leslie, Asaf Bitton, J. Gregory Jerome, Jean Paul Joseph, Roody Thermidor and Margaret E. Kruk

    Citation: Globalization and Health 2018 14:59

    Content type: Research

    Published on:

  40. The current migration flow into Europe is leading to a growing ethnically diverse population in many European countries. Now more than ever, those populations have different healthcare needs, languages, tradit...

    Authors: Céline Ledoux, Eva Pilot, Esperanza Diaz and Thomas Krafft

    Citation: Globalization and Health 2018 14:57

    Content type: Review

    Published on:

  41. Migrant children have specific health needs, and may face difficulties in accessing health care, but not enough is known about their health service use. This study aims to describe patterns of use of health se...

    Authors: Niina Markkula, Baltica Cabieses, Venla Lehti, Eleonora Uphoff, Sofia Astorga and Francisca Stutzin

    Citation: Globalization and Health 2018 14:52

    Content type: Review

    Published on:

  42. Human trafficking in the fishing industry or “sea slavery” in the Greater Mekong Subregion is reported to involve some of the most extreme forms of exploitation and abuse. A largely unregulated sector, commerc...

    Authors: Nicola S. Pocock, Reena Tadee, Kanokwan Tharawan, Wansiri Rongrongmuang, Brett Dickson, Soksreymom Suos, Ligia Kiss and Cathy Zimmerman

    Citation: Globalization and Health 2018 14:45

    Content type: Research

    Published on:

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