Cover -- Half-title -- Title -- Copyright -- Contents -- Preface -- Biographies -- Authors -- Contributors -- Notices -- Acknowledgements -- List of Abbreviations -- Reviews -- Introduction - Overview and purpose -- Origins -- Content -- What, then, is the underlying theme of the book? -- Section 1: Identifying international policies and paradigms -- Section 2: Demonstrating the epidemiological consequences of international policies -- Section 3: International health policies and their impact on access to health in middle-income countries: some experiences from Latin America -- Section 4: An analysis of the political, commercial and historical determinants of international policies -- Section 5: Principles for alternative policies for planning, management and delivery -- Section 6: A public health, strategic toolkit to implement these alternatives -- Relevance - why now? -- Definitions in health care and disease control -- Disease-specific programmes -- Global health initiatives (GHIs) -- Comprehensive health care (CHC) -- References -- Section 1 Paradigms of international policies -- Introduction to Section 1 -- 1 Donor led policies: analysis of an underlying doctrine -- To what extent have international aid agencies allocated health care and disease control to diff erent health facilities? -- The background -- The last decade: the persistence of 'market deficiencies' -- Global health initiatives and disease-control programmes -- Regulating health care markets in LMICs? -- Maturing markets and policies -- Is an international health policy reorientation in the pipeline? -- Conclusion -- References -- 2 The Achilles heel of international health policies in low- and middle-income countries -- Introduction -- The poor performance of disease-control programmes (an update) -- Integration: a key to success for disease control.

Public rather than private disease control: the need for caution -- Public disease control and private health care: a circular trap -- Poor access to health care delivery -- Evidence from pilot experiments: contracting out discretionary health care and managerial autonomy of hospitals -- Evidence from national data: contracting out equals ineffi ciency, ineffectiveness and inequity -- A comparison between Chile, Costa Rica and Colombia -- Unmet conditions for contracting out: the mechanisms of a failure -- Impact of disease-specifi c programmes and privatization of health care on health systems in LMIC s -- Discussion -- References -- Section 2 The failure of the aid paradigm: poor disease control in developing countries -- Introduction to Section 2 -- 3 Why do disease-control programmes require patients in health services to succeed in delivering? The case of malaria control in Mali -- Introduction -- Methods -- Results -- Discussion -- Conclusion -- References -- 4 How do disease-control programmes damage health care delivery in developing countries? -- Introduction -- A typology of disease-control programmes -- Vertical programmes -- Integrated programmes -- Indirect programmes -- A 'code of best practice' -- Conclusions -- References -- 5 Privatization (PPM-DOTS) strategy for tuberculosis control: how evidence-based is it? -- Summary -- Introduction -- Methodology / search strategy and selection criteria -- Results -- Increasing the case detection rate? -- Improving equity in access to tuberculosis care? -- Will private practitioners manage tuberculosis cases as well as national tuberculosis programmes? -- Efficient PPM-DOTS? -- Reduced costs for patients? -- Strengthening health systems? -- Discussion -- Conclusion -- References.

Section 3 Impact of international health policies on access to health in middle-income countries: some experiences from Latin America -- Introduction to Section 3 -- 6 Costa Rica: achievements of a heterodox health policy -- Introduction -- Methodology -- Findings -- Health policy features -- Health service characteristics -- Health service output -- Effects on human development -- Conclusions -- Acknowledgements -- References -- 7 Colombia: in vivo test of health sector privatization in the developing world -- Introduction -- Features of Colombia's reform -- Insurance coverage -- Access to and use of health services -- Disease control and heath indicators -- Financing -- Discussion -- References -- 8 Chile's neoliberal health reform: an assessment and a critique -- Introduction -- Pinochet's reform and its context -- The main features of Chile's neoliberal health reform -- The partial privatization of social security -- Segmentation and lack of solidarity between two parallel health insurance systems -- The return of democracy: restoring an underfi nanced public sector -- The impact of the reform: equity -- Financial equity -- Equity of access to care -- Equity of health status -- The impact of the reform: efficiency -- Discussion -- Glossary -- References -- Section 4 Determinants and implications of new liberal health policies: the case of India, China and Lebanon -- Introduction to Section 4 -- 9 Political and economic determinants of health care systems: the case of India -- Introduction -- Growth and reforms -- Development in the 1970s -- The reforms in the 1990s -- Assessment of the reforms -- Cutbacks in welfare -- Food distribution -- Drinking water and housing -- Health services -- Role of the state -- Who are the beneficiaries? -- Health status -- The international politics of investing in health -- Governments and corporations.

WB and WHO -- Flawed assumptions -- The poor and the rich -- The politics of knowledg e -- New concepts and theories -- Contemporary national health policies and their politics -- Politics of support and resistance -- References -- 10 An economic insight into health care provision in six Chinese counties: equity in crisis? -- Background -- Equity - theory and evidence - Theoretical framework -- Objectives and assumptions -- Data and Methods -- Results -- Indicator of health status -- Utilization of health services -- Indices of illness, utilization and financing -- Financial hardships -- Care-induced debt -- Financial barriers to care -- Discussion -- References -- 11 Health care financing and delivery in the context of conflict and crisis: the case of Lebanon -- Regional background - The Mashreq -- Background -- Financing the health sector in Lebanon: historical measures -- The Lebanese health care system -- Demographic transition and problems with data -- Socio-economic indicators and health expenditures -- Crisis of health finance and health care provision -- Mechanisms of health finance -- Public versus private sector health coverage -- Hospitals and public expenditure -- Private sector coverage -- Mutual funds -- Non-governmental organizations -- Conclusion -- References -- Section 5 Principles for alternative, publicly oriented health care policies, planning, management and delivery -- Introduction -- 12 Paradigm shifts in the health sector: mission and methods -- Part 1: The need to alter health systems' missions to deliver comprehensive care -- Comprehensive health care: medical and managerial arguments -- The fi nancial case for CHC -- Social, economic and political reasons for CHC -- Conclusion -- Part 2: The need for a methodological shift to determine priorities in health policies -- References.

13 Principles for an alternative, social and democratic health policy -- Introduction -- A social-and-democratic health policy and a publicly oriented health sector -- Machine bureaucracies -- The health care challenge: pursuing a health ideal compatible with Hippocratic principles -- The economic challenge: sustainable, viable fi nances -- The political challenge: democratizing the health sector -- The managerial challenge: successful and appropriate decentralization -- Professional bureaucracies -- Divisionalized forms -- Technical and psychological support to health professionals -- An ideal organizational model? -- Conclusions -- References -- 14 Quality standards for health care delivery and management in publicly oriented health services -- Introduction -- Ten principles as a basis for health care delivery in the public interest -- Principles in practice -- Care delivery -- Clinical practice -- Family medicine -- Community medicine -- Disease control -- Service management -- Health systems -- Conclusion -- References -- 15 Principles of publicly oriented health planning -- Introduction -- Key principles -- An integrated health system -- Minimal Activities Package -- Territorial responsibility and a discriminative responsibility for populations -- A population base -- Integrating NGOs into the system -- Health care strategies -- Reshuffl ing the PHC strategy -- District health systems -- References -- 16 A code of good practice for the management of disease-control programmes -- Disease-control activities should generally be integrated, with the exception of certain well-defined situations. They should be integrated in health centres, which offer patient-centred care -- Disease-control programmes should be integrated in not-for-profit health facilities -- Disease-control programmes should plan to avoid conflict with health care delivery.

The administration of disease-control programmes should be designed and operated to strengthen health systems.