The purpose of this study was to explore the level of integration of health promotion and disease prevention services with the curative care provided at hospitals and health centres in Addis Ababa, and to propose recommendations that could improve such an integrated health service. A quantitative approach, using an exploratory and descriptive design was applied at 22 public health facilities in Addis Ababa followed by the Delphi technique to reach consensus on ways to improve the integration of health promotion, preventive and curative care. An integrated health service (IHS) framework was used as the conceptual framework upon which the study was based. Multistage sampling involving stratified simple random sampling was applied to select hospitals and health centres while a systematic sampling technique was used to sample patients from the outpatient and inpatient medical departments. Data was collected by means of two questionnaires from patients and health service managers, respectively, following which two Delphi rounds with experts resulted in agreement on a contextually accepted integrated framework. The findings revealed that promotive and preventive services for chronic diseases were not optimally integrated in the routine health care services of the health facilities. Most health facilities lacked skilled health professionals, adequate medication and equipment to provide a comprehensive integrated service. The study emphasized the need for health service providers to undergo a paradigm shift and additional training in order to provide a comprehensive, patient-centred, integrated health service instead of only treating patients’ complaints. To assist this approach, the study affirmed the Integrated Health Service (IHS) framework as a tool which comprehensively demonstrates the cause, effect and progression of chronic diseases and the appropriate interventions which health professionals can apply in managing diseases or their risk factors. Recommendations for effective, integrated promotive and preventive health care, included the development of guidelines, protocols and policy documents for cultivating a healthy lifestyle, adopting effective disease prevention approaches, re-designing medical school curriculums, and staffing health facilities with trained and specialized staff, capacitating health facilities with the necessary equipment, medication and supplies that would enable the provision of an integrated health care service. / Health Studies / D. Litt. et Phil. (Health Studies)

Text in Afrikaans / Drug dependent adolescents do not display a clear understanding regarding the value of social work intervention during the process of rehabilation, causing them to not utilize the profession of social work effectively during drug rehabilitation. This study aimed to explore and describe the nature and contribution of social work service delivery to drug dependent adolescents from their own perspective. A qualitative research approach, an explorative research design, and a snowball sampling technique were implemented. The sample consisted of drug dependent adolescents from the Western Cape. Semi-structured interviews were executed determining the participant’s perception of the nature and contribution of social work service delivery. Amongst others, the findings indicate that: • social workers are not sufficiently prepared, trained or committed to render effective, professional services to drug dependent adolescents; • social workers need to continuously revisit their knowledge, skill and attitude regarding this specialised field of service rendering. / Social Work / M.A. (Maatskaplike Werk)

Com o processo da reforma psiquiátrica brasileira começam a ocorrer transformações do modelo assistencial em saúde mental, passando de uma abordagem voltada apenas para a doença, para outra que considera a existência de sujeitos com diversas necessidades e potencialidades. Nesse processo de mudanças faz-se importante a criação de uma rede de serviços que atuem conforme a lógica da atenção psicossocial aos usuários de forma singular, promovendo a autonomia e a reinserção social destes. Dentre esses serviços, é possível citar os Centros de Atenção Psicossocial. Este estudo possui o objetivo geral de discutir a relação social entre trabalhadores que atuam no CAPS e o usuário do serviço. Trata-se de uma pesquisa de natureza qualitativa, de abordagem fenomenológica, com a utilização do referencial de Alfred Schutz. Este estudo foi realizado em um Centro de Atenção Psicossocial, localizado no município de Chapecó, no estado de Santa Catarina. Os sujeitos do estudo constituíram-se em 14 trabalhadores e 14 usuários deste CAPS. A coleta das informações foi realizada por meio de entrevista fenomenológica com os participantes do estudo, nos meses de janeiro e fevereiro de 2011. As categorias que expressam as expectativas dos usuários quanto às ações dos trabalhadores do serviço relacionam-se com a espera pela sua melhora, com a expectativa de melhorias no serviço e pela expectativa de atenção dos trabalhadores do CAPS. Quanto aos trabalhadores, estes expressam a intencionalidade das suas ações em promover a autonomia e a qualidade de vida dos usuários; e na intenção de que ocorram melhorias na administração pública, no sentido de melhorar a atenção aos usuários do serviço. A partir da análise das expectativas dos usuários e das intenções dos trabalhadores quanto às ações no CAPS identificou-se convergências especialmente quanto à melhora dos usuários e quanto a melhorias no serviço público. A relação social estabelecida entre usuários e trabalhadores demonstrou ser permeada pela atenção psicossocial que os trabalhadores desenvolvem no serviço, pela expressão de que os usuários podem obter ajuda dos trabalhadores, pela relação de confiança e vínculo que vai sendo construída no cotidiano do serviço. Assim, é preciso que nos serviços de saúde mental a relação social entre usuários e trabalhadores esteja voltada para as necessidades de saúde dos usuários e para maneiras de melhor intervir sobre elas. / With the process of psychiatric reform, it begins to happen changes in the mental health care model, from an approach focused only in the illness, to other one, that considers the existence of the subjects themselves, with its various needs and potentialities. In this process of changes, it is important to create a network of services capable to act according to the psychosocial logic of attention to the user in a singular form, promoting their autonomy and social reinsertion. Among these services, it is possible to quote the Psychosocial Care Center (CAPS). The present study aims to discuss the social relation between the workers that act in a CAPS and the users of the service. It is a qualitative research, with a phenomenological approach, according to Alfred Schutz's referential. The study was carried out in a CAPS in Chapecó City, Santa Catarina State, Brazil. Actors of the study were 14 workers and 14 users of the CAPS. Data collection was realized with phenomenological interview, between January and February 2011. The categories that express the expectations of the users regarding the actions of the service’s workers are related to the wait for improving, to the expectation for improvements in the service and to the expectation of the worker’s attention. As for the workers, they express the intentionality of their actions in promoting the users’ autonomy and quality of life; as well as the intentionality that occur improvements in the public administration, in order to improve the attention to the users of the CAPS. From the analysis of the expectations of the users and the intentionality of the workers related to the actions in the CAPS, it were identified convergences especially regarding the improvement of the users and the public service. The social relation established between users and workers has shown to be permeated by psychosocial attention that the workers develop in the service, by the expression that users can obtain help from the workers, by the trust relation and the establishment of bonds that are constructed in the quotidian of the service. Thus, it is necessary that in the mental health services, the social relation between users and workers be focused on the health needs of the users and in the better manners of intervening upon them. / Con el proceso de la reforma psiquiátrica brasileña, transformaciones del modelo de atención en salud mental comenzaron a ocurrir, pasando de un abordaje basado únicamente para la enfermedad a otra que considera la existencia de sujetos con distintas necesidades y potenciales. En ese proceso de cambios, es importante la creación de una red de servicios que actúen de acuerdo con la lógica de la atención psicosocial a los usuarios de manera singular, con la promoción de su autonomía y de su reinserción social. Entre esos servicios, es posible mencionar los Centros de Atención Psicosocial (CAPS). Este estudio tiene por objetivo general la discusión de la relación social entre trabajadores que actúan en el CAPS y los usuarios del servicio. Se trata de una investigación de naturaleza cuantitativa, de abordaje fenomenológico, con el uso del referencial de Alfred Schutz. Se realizó este estudio en un CAPS ubicado en el Municipio de Chapecó, en el Estado de Santa Catarina. Los objetos del estudio son 14 trabajadores y 14 usuarios del CAPS. El recogido de las informaciones se realizó a través de entrevista fenomenológica con los participantes del estudio, en los meses de enero y febrero de 2011. Las categorías que expresan las expectativas de los usuarios en cuanto a las acciones de los trabajadores del servicio se relacionan con la espera por su mejora, con la expectativa de mejora en el servicio y por la expectativa de atención de los trabajadores del CAPS. En lo que se refiere a los trabajadores, éstos expresaron la intención de sus acciones en promover la autonomía y la calidad de vida de los usuarios; y en la intención de que haya mejoras en la administración pública, en el sentido de desarrollar la atención a los usuarios del servicio. A partir del análisis de las expectativas de los usuarios y de las intenciones de los trabajadores en relación a las acciones en el CAPS, se identificó convergencias especialmente en cuanto a la mejora de los usuarios y en el servicio público. La relación establecida entre usuarios y trabajadores demostró ser permeada por la atención psicosocial que los trabajadores desarrollan en el servicio, por la expresión de que los usuarios pueden obtener ayuda de los trabajadores, por la relación de confianza y vínculo que se construye en el cotidiano del servicio. Así, es necesario que en los servicios de salud metal la relación social entre usuarios y trabajadores esté dirigida a las necesidades de salud de los usuarios y a maneras de mejor intervenir sobre ellas.

A partir das mudanças que vêm ocorrendo na política de saúde mental, surgiram várias inquietações no que diz respeito aos resultados deste processo para os usuários, familiares, e profissionais dos Centros de Atenção Psicossocial (CAPS). Estas inquietações se estenderam também ao significado que estava sendo constituído por estes sujeitos sobre os CAPS. Surgiu, então, o desejo de estudar as identidades que estão emergindo destes sujeitos que atuam no cenário do CAPS, no que concerne a sua participação e integração a este serviço, como também conhecer os significados que estão sendo construídos a respeito destes serviços. O presente estudo possui os seguintes objetivos: Conhecer a identidade dos usuários, familiares e profissionais que atuam no cenário do CAPS e conhecer os significados relacionados ao CAPS. A pesquisa foi realizada com onze usuários, onze familiares e doze profissionais. O estudo seguiu o caminho teórico-metodológico da Teoria Ego-Ecológica, proposto por Zavalloni. Esta teoria permite conhecer a identidade do indivíduo, suas peculiaridades e sua realidade através da representação que ele possui acerca de si mesmo e do grupo. Esta teoria permite também compreender cada sujeito/identidade inserido em seu contexto, assim como as relações estabelecidas entre ele e seus pares e entre eles e os sujeitos de outros grupos com os quais se relacionam. Esta rede de relacionamentos intra e intergrupal possui significados que o Inventário Multifásico de Identidade Social (IMIS) permitiu conhecer e analisar de forma criteriosa e sensível. Este trabalho revelou o usuário com uma autopercepção fortificada, com esperança de constituir uma nova família e conseguir um emprego digno. Contudo, as mudanças observadas na identidade dos sujeitos com diagnóstico de transtorno mental não se estendem aos seus familiares que continuam sendo vistos de forma negativa, tanto pelos usuários como pelos profissionais. Para que a reabilitação social ocorra os familiares precisam ser incluídos neste processo, precisam se implicar mais no tratamento de seus familiares, e também os usuários e profissionais precisam modificar o modo como percebem e se relacionam com os familiares. O presente estudo mostrou que, apesar das dificuldades encontradas, o modelo psicossocial tem beneficiado a pessoa com transtorno mental, porém observa-se uma certa paralisia no movimento da Reforma Psiquiátrica. Indubitavelmente o modelo psicossocial beneficia a pessoa com transtorno mental severo, contudo, atualmente, corre-se o risco da cronificação destes sujeitos dentro do CAPS. O movimento da Reforma Psiquiátrica conseguiu mostrar que o modelo manicomial é ineficaz no tratamento das pessoas com transtorno mental, porém esse é só o começo do processo de reabilitação psicossocial. Faz-se necessário avançar neste processo e ir além do CAPS para que os usuários alcancem a vida. A falta de medicação e de alimentação, o número insuficiente de serviços e funcionários e a dificuldade em realizar uma assistência adequada vêm sobrecarregando e gerando estresse nos profissionais e, como um dos profissionais entrevistados fala, “O CAPS é uma estrutura em crescimento, que não sabemos aonde vai dar”. / Many issues have come up due to the changes in the mental health policies concerning users, relatives and professionals at the Day-Care Units (CAPS). Those issues also consisted of the idea that was being made of the Day-Care Units by such individuals. This work has the purpose of studying the identities that are emerging from the perspective of such individuals who act on the Day-Care Unit scene, considering their roles and their commitment to that service, and of knowing how those services are being perceived by the individuals. The present study aims at: knowing the identity of the users, related and professional who act on the Day-Care Unit scene, and putting in evidence the meanings attributed to the Day-Care Unit. The research includes eleven users, eleven family members and twelve professionals. The study is methodologically based on the Ego-ecologic Theory by Zavalloni. This method allows to know the identity of the subject, his/her peculiarities and reality by means of selfrepresentation and the representation made by him/her about the group. This theory also enables understanding of the subject/identity as inserted in his/her environment, likewise the relations within themselves, their pairs and subjects from other environments. This internal and external network of relationships has meanings capable of accurate and sensible analysis by means of the Multistage Social Identity Inquirer. This work reveals the user with the strengthened self-awareness, hoping to constitute family and getting a fair job. However, the changes seen in mentally impaired are not followed by their relatives, who are still seen negatively both by users and professionals. In order that the social rehabilitation occurs, relatives must be included in the process, thus improving the bonds to their related ones. Users and professionals must modify the way they see and relate to their relatives too. The present study shows that, despite difficulties, the psychosocial model has been doing good to the mentally impaired, although noticing a certain paralysis of the Psychiatric Reform movement. No doubt the psychosocial model benefit the subject under severe mental impairment, however risking nowadays the perennial stay of those subjects within the Day-Care Unit. The movement of Psychiatric Reform has shown that the asylum model is not efficient in treating people mentally impaired, although psychosocial rehabilitation is just in the beginning. It is fundamental to move such process forward and beyond Day-Care Units so that the users can reach life. Lack of medication, food, services and staff to a proper care overload professionals, and quoting: “The Day-Care Unit is a growing structure which we know not where it is going to.”

Abstract Understanding and attitudes of the public towards the current Health Care Reform This thesis summarizes the basic facts about the current reform within the Health Care Sector and how it is being perceived by the general public. The theoretical part focuses on the basic information about the development of the Health Care Sector in the Czech Republic and its current reform. The development of the Health Care Sector from the year of 1918 until present is highlighted. At the beginning of the last decade of the 20th century, a new set of laws were passed, which triggered the initial reform of the Czech Health Care Sector. However, a period of passivity regarding subsequent legislation has resulted in the present problems. Further, there is a focus on current Health Care Reform enquiring: why the reform is needed, the nature of its stages and its legislative and non-legislative changes. Only a small part of the reform measures came into force. This included the introduction of regulation fees, the introduction of an `annual safe limit{\crq}, and the pricing and payment for medication. The practical part presents the research findings in relation to the issues mentioned above. The research part of the thesis, carried out using questionnaires, is concerned with the views of the public with respect to current Health Care Reform and investigates whether it has been understood by the public. The research shows that most of the respondents disagree with the reform and think that it is not developing in the right direction. The majority of respondents with this view were found to be within the age group of 60 and over, and within the group of respondents with a basic level or vocational education. Further, the research suggests that the public is not adequately informed about the new Health Care Reform, and therefore demonstrates a lack of understanding of its nature. In addition, the current political climate suggests that the public may lose interest in these issues and will become disengaged with the reform without further consideration.

Com o processo da reforma psiquiátrica brasileira começam a ocorrer transformações do modelo assistencial em saúde mental, passando de uma abordagem voltada apenas para a doença, para outra que considera a existência de sujeitos com diversas necessidades e potencialidades. Nesse processo de mudanças faz-se importante a criação de uma rede de serviços que atuem conforme a lógica da atenção psicossocial aos usuários de forma singular, promovendo a autonomia e a reinserção social destes. Dentre esses serviços, é possível citar os Centros de Atenção Psicossocial. Este estudo possui o objetivo geral de discutir a relação social entre trabalhadores que atuam no CAPS e o usuário do serviço. Trata-se de uma pesquisa de natureza qualitativa, de abordagem fenomenológica, com a utilização do referencial de Alfred Schutz. Este estudo foi realizado em um Centro de Atenção Psicossocial, localizado no município de Chapecó, no estado de Santa Catarina. Os sujeitos do estudo constituíram-se em 14 trabalhadores e 14 usuários deste CAPS. A coleta das informações foi realizada por meio de entrevista fenomenológica com os participantes do estudo, nos meses de janeiro e fevereiro de 2011. As categorias que expressam as expectativas dos usuários quanto às ações dos trabalhadores do serviço relacionam-se com a espera pela sua melhora, com a expectativa de melhorias no serviço e pela expectativa de atenção dos trabalhadores do CAPS. Quanto aos trabalhadores, estes expressam a intencionalidade das suas ações em promover a autonomia e a qualidade de vida dos usuários; e na intenção de que ocorram melhorias na administração pública, no sentido de melhorar a atenção aos usuários do serviço. A partir da análise das expectativas dos usuários e das intenções dos trabalhadores quanto às ações no CAPS identificou-se convergências especialmente quanto à melhora dos usuários e quanto a melhorias no serviço público. A relação social estabelecida entre usuários e trabalhadores demonstrou ser permeada pela atenção psicossocial que os trabalhadores desenvolvem no serviço, pela expressão de que os usuários podem obter ajuda dos trabalhadores, pela relação de confiança e vínculo que vai sendo construída no cotidiano do serviço. Assim, é preciso que nos serviços de saúde mental a relação social entre usuários e trabalhadores esteja voltada para as necessidades de saúde dos usuários e para maneiras de melhor intervir sobre elas. / With the process of psychiatric reform, it begins to happen changes in the mental health care model, from an approach focused only in the illness, to other one, that considers the existence of the subjects themselves, with its various needs and potentialities. In this process of changes, it is important to create a network of services capable to act according to the psychosocial logic of attention to the user in a singular form, promoting their autonomy and social reinsertion. Among these services, it is possible to quote the Psychosocial Care Center (CAPS). The present study aims to discuss the social relation between the workers that act in a CAPS and the users of the service. It is a qualitative research, with a phenomenological approach, according to Alfred Schutz's referential. The study was carried out in a CAPS in Chapecó City, Santa Catarina State, Brazil. Actors of the study were 14 workers and 14 users of the CAPS. Data collection was realized with phenomenological interview, between January and February 2011. The categories that express the expectations of the users regarding the actions of the service’s workers are related to the wait for improving, to the expectation for improvements in the service and to the expectation of the worker’s attention. As for the workers, they express the intentionality of their actions in promoting the users’ autonomy and quality of life; as well as the intentionality that occur improvements in the public administration, in order to improve the attention to the users of the CAPS. From the analysis of the expectations of the users and the intentionality of the workers related to the actions in the CAPS, it were identified convergences especially regarding the improvement of the users and the public service. The social relation established between users and workers has shown to be permeated by psychosocial attention that the workers develop in the service, by the expression that users can obtain help from the workers, by the trust relation and the establishment of bonds that are constructed in the quotidian of the service. Thus, it is necessary that in the mental health services, the social relation between users and workers be focused on the health needs of the users and in the better manners of intervening upon them. / Con el proceso de la reforma psiquiátrica brasileña, transformaciones del modelo de atención en salud mental comenzaron a ocurrir, pasando de un abordaje basado únicamente para la enfermedad a otra que considera la existencia de sujetos con distintas necesidades y potenciales. En ese proceso de cambios, es importante la creación de una red de servicios que actúen de acuerdo con la lógica de la atención psicosocial a los usuarios de manera singular, con la promoción de su autonomía y de su reinserción social. Entre esos servicios, es posible mencionar los Centros de Atención Psicosocial (CAPS). Este estudio tiene por objetivo general la discusión de la relación social entre trabajadores que actúan en el CAPS y los usuarios del servicio. Se trata de una investigación de naturaleza cuantitativa, de abordaje fenomenológico, con el uso del referencial de Alfred Schutz. Se realizó este estudio en un CAPS ubicado en el Municipio de Chapecó, en el Estado de Santa Catarina. Los objetos del estudio son 14 trabajadores y 14 usuarios del CAPS. El recogido de las informaciones se realizó a través de entrevista fenomenológica con los participantes del estudio, en los meses de enero y febrero de 2011. Las categorías que expresan las expectativas de los usuarios en cuanto a las acciones de los trabajadores del servicio se relacionan con la espera por su mejora, con la expectativa de mejora en el servicio y por la expectativa de atención de los trabajadores del CAPS. En lo que se refiere a los trabajadores, éstos expresaron la intención de sus acciones en promover la autonomía y la calidad de vida de los usuarios; y en la intención de que haya mejoras en la administración pública, en el sentido de desarrollar la atención a los usuarios del servicio. A partir del análisis de las expectativas de los usuarios y de las intenciones de los trabajadores en relación a las acciones en el CAPS, se identificó convergencias especialmente en cuanto a la mejora de los usuarios y en el servicio público. La relación establecida entre usuarios y trabajadores demostró ser permeada por la atención psicosocial que los trabajadores desarrollan en el servicio, por la expresión de que los usuarios pueden obtener ayuda de los trabajadores, por la relación de confianza y vínculo que se construye en el cotidiano del servicio. Así, es necesario que en los servicios de salud metal la relación social entre usuarios y trabajadores esté dirigida a las necesidades de salud de los usuarios y a maneras de mejor intervenir sobre ellas.

Submitted in fulfillment of the requirements for the Degree Mast in Technology: Public Management, Durban University of Technology, Durban, South Africa, 2017. / The South African healthcare sector stands at the threshold of major restructuring in an attempt to address inadequacies as a result of fragmentation of health services in apartheid South Africa. The level of health services, particularly in rural areas, has decreased and has led to reduced quality and productivity of health services. For individuals residing in rural communities, access to health services can be arduous. Delivery of essential services has to meet the needs of marginalised people who live in remote areas. In light of the above, the department of health is faced with growing expectations from citizens to use resources efficiently and effectively and to ensure that healthcare is affordable and accessible to all. National Health Insurance (NHI) is intended to bring about reform that will improve service provision. The researcher undertook this study to explore healthcare challenges faced by South Africa and its people and how far progressive realisation of access to healthcare, as enshrined in the 1996 Constitution, is being implemented. A case study using a mixed method approach was adopted. The literature reviewed indicated that issues of remuneration, ageing infrastructure and general management challenges, including financial management, are among the challenges that continue to hamper the public health system in South Africa. In addition, the HIV/AIDS epidemic has created more demand for healthcare as many more people become sick. The Green Paper outlining the government’s broad policy proposals for NHI, released in August 2011, makes it clear that NHI is a long-term project that will be rolled out over 14 years. It aims to promote efficiency and equity to ensure that all South Africans have access to affordable, quality healthcare. The findings of this study are useful not only to the case study institution, but to all District Hospitals, especially the department of health and the public management sector and may assist in taking the NHI forward. / M

The thesis is focused on health care funding in Czech Republic. Comparative analysis confront current Czech health care system with effective one used in Netherlands. First part explains importance of health care activities in welfare state as a public interest priority that influence national economy. Second part presents positive and negative aspects of each type of health care system used abroad. Summary of all these fund sources, type of compensations and health care providers characteristics shapes a hypotetical effective system that can be implemented into a practice of universal health insurance system with detailed considaration of historical, political, legal and social aspects of Czech Republic. According to all these analysis I aim to recommend healt care system improvements that would enhance health care quality.

In Peru, The National Health Authority (SUSALUD) is granted the responsibility to promote, protect and defend the health rights of every citizen. However, in the Peruvian Health System (PHS) there exists an insufficient culture of health rights, a low level of knowledge of health rights by the population, and a limited degree of cooperation between users, providers and funders. In light of this limited popular participation in the health rights of the citizenry, it has been necessary for SUSALUD to pursue various activities in order to promote the exercise of health rights by Peruvians. Among the strategies implemented are the development of Organized Boards of Users (OBU) and a Program of Integrated Actions for the Promotion of Health Rights (PIAPHI). The aim of both interventions is to increase the level of trust between citizens and government, which fosters and strengthens the capacity of citizens to pursue their health rights. In this article we begin with a brief presentation on the state of knowledge, attitudes and practices of users of the health system regarding their rights. Then we explain both programs, their goals and procedures, and a general description of their activities. Also, some indicators of process and some results are presented along with discussion and future prospects. We believe that the gradual implementation of the OBU and PIAPHI programs will enhance the participation of Peruvians in their health system, and will contribute positively to their empowerment and the pursuit of their health rights. / In Peru, The National Health Authority (SUSALUD) is granted the responsibility to promote, protect and defend the health rights of every citizen. However, in the Peruvian Health System (PHS) there exists an insufficient culture of health rights, a low level of knowledge of health rights by the population, and a limited degree of cooperation between users, providers and funders. In light of this limited popular participation in the health rights of the citizenry, it has been necessary for SUSALUD to pursue various activities in order to promote the exercise of health rights by Peruvians. Among the strategies implemented are the development of Organized Boards of Users (OBU) and a Program of Integrated Actions for the Promotion of Health Rights (PIAPHI). The aim of both interventions is to increase the level of trust between citizens and government, which fosters and strengthens the capacity of citizens to pursue their health rights. In this article we begin with a brief presentation on the state of knowledge, attitudes and practices of users of the health system regarding their rights. Then we explain both programs, their goals and procedures, and a general description of their activities. Also, some indicators of process and some results are presented along with discussion and future prospects. We believe that the gradual implementation of the OBU and PIAPHI programs will enhance the participation of Peruvians in their health system, and will contribute positively to their empowerment and the pursuit of their health rights. / Revisión por pares

Jana Leichterová Conservative Criticism of Obamacare and its Transformation in the Context of Donald Trump Running for President Abstract The thesis deals with the debate over the health care reforms in the United States. It focuses specifically on the debate over the Affordable Care Act, also known as Obamacare, a health care reform initiated by President Barack Obama that was signed into law in March 2010. The goal of the thesis is to identify the main arguments of the conservative criticism of the Affordable Care Act, and to determine whether the debate transformed with the emergence of Donald Trump onto the political scene. The thesis provides historical context of the three main approaches to the health care policies in the United States throughout the 20th century: the Social Security path of strong government in the 1930s, the mixed "American way" with government providing social benefits to citizens through private institutions in the 1970s, and the approach of unregulated free market since the 1980s. Obama's health care originates in the urge for a national solution of the high number of uninsured citizens (more than 50 million in 2009) and rising cost of health care. The reform has three essential pillars: 1. the reform of the health insurance market that unifies the diverse state approaches and...