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Since the fall of the Soviet Union in 1991, the countries of Central and Eastern Europe (CEE) have undergone profound political, economic, and social changes. As the countries’ communist regimes ended, governments were faced with developing new health systems, financing these systems, and instituting reforms in the countries’ existing mental health care systems. Yet, over a quarter of a century since the dissolution of the Soviet Union, the transformation of mental health systems remains incomplete. As a World Health Organization (WHO) assessment writes, “Are mental health services moving forward in Central and Eastern Europe? Of course, a quick answer is either yes or no. Or, rather, the correct answer is both yes and no” (Saraceno and Saxena, 2005)…
In the quarter century since the fall of communist rule, the countries of Central and Eastern Europe (CEE) have made respectable progress in reforming their mental health care systems. However, this progress is far from complete. Mental health care in the region remains outdated and ineffective compared to international standards. Future reform is a crucial task: CEE has one of the highest proportions of disease burden due to mental and substance use disorders in the world (Krupchanka and Winkler, 2016, p. 96), among the highest rates of suicide worldwide (WHO, 2018), and extremely high—and rising—levels of alcohol consumption (Krupchanka and Winkler, 2016, p. 96)…
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Pay-for-performance (P4P) is an emerging payment mechanism that, unlike previous mechanisms, remunerates health providers based on performance in order to increase efficiencies in health systems. P4P designs vary by healthcare settings, health measures, the form of reward, and the basis for reward. Countries around the globe are developing P4P designs specific to the needs of their citizens, leading to numerous forms of P4P programs with diverse measures and disparate outcomes. Despite P4P program prevalence, P4P has been yet to be comprehensively evaluated, making it difficult to assess overall P4P effectiveness. Results from OECD countries show that P4P programs have galvanized payers and providers to better measure health care quantity and quality. Select low-income countries have implemented P4P at a national level, strengthening health system capacity through collection and analysis of population health data. Early research at all country income levels reveals that there is promise to improve healthcare efficiencies through P4P, but more research must be conducted in order to know the optimum payment incentive and channel for payment distribution, as well as the most effective means to change provider behavior.
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The United Nations’ sustainable development goals (SDGs) set an ambitious agenda for achieving better global health by 2030. The agenda includes reducing global maternal and infant mortality, ending epidemics such as AIDS, tuberculosis, and malaria, and achieving universal health coverage. Reaching these goals will require well-functioning health systems. As health systems are highly labor intensive, the availability and performance of health workers will have a significant impact on whether these goals are achieved…
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We first explore the historical development of social capital and how the conceptualization and the proposed definitions of social capital have evolved over time and continue to develop. Although many scholars and academics have explored the term social capital, there are four definitions, as proposed by Bourdieu (1986), Coleman (1988), Putnam (1993, 2000), and the World Bank that have been dominant in the academic debate. The social capital definitions included in the papers of several economists are also explored. The varying definitions and descriptions of social capital point to the fact that there is no one distinct definition, but rather, social capital can be attributed to conceptual and empirical ideas based on social interactions, relations, structures, and values. The empirical measurements of social capital throughout the book are then evaluated in terms of their usefulness in explaining the relationship between social capital and health, based on three criteria…