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1 – 4 of 4Benjamin Sunday Uzochukwu, Chinyere Cecilia Okeke, Joyce Ogwezi, Benedict Emunemu, Felicia Onibon, Bassey Ebenso, Tolib Mirzoev and Ghazala Mir
The importance of social exclusion and the disadvantage experienced by many minority ethnic and religious populations are rooted in SDG 10. To address this exclusion effectively…
Abstract
Purpose
The importance of social exclusion and the disadvantage experienced by many minority ethnic and religious populations are rooted in SDG 10. To address this exclusion effectively it is important to understand their key drivers. This paper aimed to establish the key drivers of exclusion and their outcomes in Nigeria.
Design/methodology/approach
The methods involved a scoping review of literature and stakeholder workshops that focused on drivers of social exclusion of religious and ethnic minorities in public institutions.
Findings
At the macro level, the drivers include ineffective centralized federal State, competition for resources and power among groups, geographic developmental divide and socio-cultural/religious issues. At the meso-level are institutional rules and competition for resources, stereotypes and misconceptions, barriers to access and service provision. At the micro-level are socio-economic status and health-seeking behaviour. The perceived impact of social exclusion included increasing illiteracy, lack of employment, deteriorating health care services, increased social vices, communal clashes and insurgencies and vulnerability to exploitation and humiliation. These drivers must be taken into consideration in the development of interventions for preventing or reducing social exclusion of ethnic and religious minorities from public services.
Originality/value
This is a case of co-production by all the stakeholders and a novel way for the identification of drivers of social exclusion in public services in Nigeria. It is the first step towards solving the problem of exclusion and has implications for the achievement of SDG 10 in Nigeria.
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Keywords
Tolib N. Mirzoev, Andrew T. Green and James N. Newell
The purpose of this paper is to provide an up‐to‐date overview of Tajikistan's health system, focusing on the main factors affecting health systems development. The wider…
Abstract
Purpose
The purpose of this paper is to provide an up‐to‐date overview of Tajikistan's health system, focusing on the main factors affecting health systems development. The wider contextual environment is to be explored, focusing on political, social and economic issues. Different elements of the health system including health policy, governance, service delivery, human resources and health financing are reviewed in the light of their development over the past decade.
Design/methodology/approach
The paper shows that the Republic of Tajikistan is in transition. Formerly one of the most neglected republics within the USSR, the country became independent in 1990 and faced the civil conflict shortly thereafter. In the last few years there have been major public sector reforms with health reforms formally launched in the late 1990s. Little information about current Tajikistan is widely available.
Findings
The paper finds that the progress of health reforms in Tajikistan has been relatively slow compared with neighbouring Kazakhstan and Kyrgyzstan. This is largely due to the effects of civil war in the mid‐1990s and significant out‐migration of qualified experts, but it can also be attributed to an inability of central government to adequately adapt to the requirements of transition.
Originality/value
The paper shows that many problems are still to be overcome by the health system, ranging from operational issues related to service delivery to strategic issues such as formulating an explicit privatisation policy, reducing fragmentation of, and aligning, external aid. However, some recent developments, such as adoption of a country health reform conception, a health financing strategy, and willingness of central government to improve coordination, suggest that improvements are possible.
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Mayeh Omar, Ehsanullah Tarin, Kazem Ashjaei, Tolib Mirzoev and Mubashar Riaz Sheikh
The purpose of this paper is to review the Government initiative for developing the in‐country capacity of the National Public Health Management Centre (NPMC) in Tabriz. The UNDP…
Abstract
Purpose
The purpose of this paper is to review the Government initiative for developing the in‐country capacity of the National Public Health Management Centre (NPMC) in Tabriz. The UNDP definition of capacity has been used as a framework for assessment with the primary focus of the current assessment being on the training component.
Design/methodology/approach
The paper shows that Iran, which is a lower‐middle income country, has a network of training institutions for both pre‐service and continuing education of its human resources in health. This collaborative initiative between NPMC, Nuffield Centre for International Health and Development (NCIHD) and World Health Organization (WHO), attempted to create conditions for designing, organising and conducting a training programme in health planning and management for mid‐level health managers in Iran.
Findings
The paper finds that the experience of capacity development through training, described here, is in contrast with usual practice, where candidates are sent abroad for training. Overall, the process for developing in‐country capacity of a local institute by a foreign institute was well thought out. However, there are some lessons to be learned from the process.
Originality/value
The paper shows that capacity has been built in NPMC for organising in‐country short course on health planning and management for health sector reform. The paper concludes by arguing that, in order to sustain these training programmes over a long period of time, in addition to including training in its mandate, NPMC should: consider networking with allied institutions in the country and beyond for sharing knowledge; and make twinning arrangements with a foreign institute for continuously upgrading the knowledge and skills of its trainers.
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Kayla Halsey, Salameh Alarood, Mohammed Nawaiseh and Ghazala Mir
Refugees commonly face inequitable access to health care services in their host country. This study aimed to identify factors influence refugee access to health services and to…
Abstract
Purpose
Refugees commonly face inequitable access to health care services in their host country. This study aimed to identify factors influence refugee access to health services and to assess perceptions of barriers to health care for different refugee groups in Jordan.
Design/methodology/approach
In-depth interviews were combined with document analysis and analyzed using thematic and framework methods.
Findings
Findings highlighted inequitable access to health services between different refugee groups. Unlike Palestinian refugees from the West Bank, Palestinian refugees from Gaza faced financial barriers to access health care as a result of citizenship status, which affected their health insurance, referrals for health care and legal right to work. Syrian refugees similarly lacked Jordanian citizenship and health insurance and mainly depended on UNHCR for health services, though some were able to acquire work permits and pay for private care.
Originality/value
This study demonstrates a need for politically and economically appropriate policies to minimize the disparity of health care access among these refugee groups.
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