کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
7328459 1475969 2018 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Rethinking health sector procurement as developmental linkages in East Africa
ترجمه فارسی عنوان
بازخورد دادن بخش های بهداشتی به عنوان ارتباطات توسعه در شرق آفریقا
کلمات کلیدی
تدارکات، دسترسی به درمان، تولید محلی دارو، لوازم پزشکی، تانزانیا، کنیا، ارتباطات سلامت-صنعت، حکومت نظام سلامت،
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی سیاست های بهداشت و سلامت عمومی
چکیده انگلیسی
Health care forms a large economic sector in all countries, and procurement of medicines and other essential commodities necessarily creates economic linkages between a country's health sector and local and international industrial development. These procurement processes may be positive or negative in their effects on populations' access to appropriate treatment and on local industrial development, yet procurement in low and middle income countries (LMICs) remains under-studied: generally analysed, when addressed at all, as a public sector technical and organisational challenge rather than a social and economic element of health system governance shaping its links to the wider economy. This article uses fieldwork in Tanzania and Kenya in 2012-15 to analyse procurement of essential medicines and supplies as a governance process for the health system and its industrial links, drawing on aspects of global value chain theory. We describe procurement work processes as experienced by front line staff in public, faith-based and private sectors, linking these experiences to wholesale funding sources and purchasing practices, and examining their implications for medicines access and for local industrial development within these East African countries. We show that in a context of poor access to reliable medicines, extensive reliance on private medicines purchase, and increasing globalisation of procurement systems, domestic linkages between health and industrial sectors have been weakened, especially in Tanzania. We argue in consequence for a more developmental perspective on health sector procurement design, including closer policy attention to strengthening vertical and horizontal relational working within local health-industry value chains, in the interests of both wider access to treatment and improved industrial development in Africa.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Social Science & Medicine - Volume 200, March 2018, Pages 182-189
نویسندگان
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