<p> Gross inequality in access to health services is a common problem in developing countries like Panama. This study responds to the current shortage of physicians from economically depressed communities in Panama. By using qualitative research methods, I examined the personal, financial, curricular and environmental factors that shape low-income students&rsquo; commitment to become physicians; the forces that shape these medical students to practice medicine once they graduate; and how policies and institutional practices in medical schools in Panama influence rates at which low-income students become physicians. Specifically, data sources were used to explore how the nation&rsquo;s educational policies, as well as recruitment, admissions, and student support practices in medical schools, influence rates at which low-income students become physicians. Documents were analyzed to determine statistical trends in medical school enrollment and completion for some of the selected medical schools; and the availability and effectiveness of various policy initiatives enacted to increase the production of physicians across the country. </p><p> Interviews were conducted with senior academic officers of medical schools (e.g., vice provost, deans and directors) and others who know much about the country&rsquo;s current human resources challenges in medicine (e.g., a former minister of health, the deputy minister of education, and the health senior adviser to the president of Panama). Interviews with these stakeholders provided insights into the educational, political, and economic forces that shape whoever enrolls in and ultimately completes medical school. Additionally, recent graduates or students in their final year of medical school from four schools of medicine in the Republic of Panama participated in focus groups, to offer information into the personal, familiar and institutional factors that supported and undermined low-income students&rsquo; goals of becoming doctors. Some attention was paid to socioeconomic demographics of communities in which certified physicians ultimately choose to practice. </p><p> The findings of this study provide Panamanian policymakers with valuable information for defining better approaches to train physicians for underserved areas and may help Panama achieve compliance with the millennium objectives that were agreed to by member countries of the World Health Organization in 2000. Finally, implications for future research on the training of low-income students to become physicians in underserved communities are proposed.</p>

Health care systems in many countries around the world have been subject to major reform initiatives since 1980s and 1990s. The main rationale for reform was an increasing need to control costs in health care as the countries struggled to adapt to the global economic conjuncture and deal with their financial problems. The movement to reform health care arose in that context and spread amongst health care experts and policy makers. The aim of this study is to understand how reforms were initiated and what forces drove them. This topic is addressed through the case studies of change in health care policies in Turkey and the Czech Republic, both of which having experienced the influence of global economic trends, yet are defined by fundamentally different economic, political and social conditions. The findings of the study support that health policy ideas were diffused to the two countries via international policy networks; domestic contexts facilitated the diffusion. Interest groups were important actors in both countries, but the role played by various groups differed in the two countries. Finally, the countries appear to have tendency to converge to a certain degree with regard to their health financing system. Key words: Health care reform, policy diffusion, globalization, Czech Republic, Turkey.

Thesis (M. Soc. Sc.)--University of Hong Kong, 1983.

The existing literature about the causes of welfare state change, including health care reform, emphasizes stability, yet there is evidence of remarkable changes taking place in welfare systems in much of the developing world. This study analyzes health care reform in Ghana, a country which has experienced significant path-departing changes in just four decades (1957-2003). These changes – the establishment of a National Health Service system with deep (first-dollar) coverage, the introduction of a user-fee system, and the transition to a social health insurance scheme – have been pursued despite key countervailing factors, especially the high political costs associated with them. The study argues that to adequately account for these changes, the policy process should be given special consideration, particularly through the examination of how new policy proposals moved onto the agenda; how they were formulated, adopted, implemented and sustained; and how the reformers managed the entire reform process over time. Based on this analysis, I identified three main interconnected contextual and agential explanatory factors: (a) conjunctural factors, which created windows of opportunity for the changes to occur; (b) policy entrepreneurs, whose leadership, commitment and strategies helped in taking advantage of these opportunities to propel, sponsor, design, adopt, implement and sustain the policy changes; and (c) the concentrated institutional configuration of Ghana, which limited the number and scope of the veto points available to interest groups opposed to the proposed changes. While these three factors contributed to why and how the changes occurred, I identified policy entrepreneurs’ commitment, leadership and strategies, including the feedback effects of those strategies, as the most crucial factors. The study contributes to existing health policy literature by showing how perspectives such as the window of opportunity thesis, the dynamic political process model, the historical institutionalist approach to radical policy change and, finally, the ideational scholarship on framing processes can be combined to enrich our understanding of radical policy change. The study also introduces additional mechanisms of policy change that involve the use of repressive strategies before suggesting some modifications to a number of widely-shared assumptions within the welfare state literature focusing on path dependency, globalization, partisan ideology and vested interests.

This thesis examines some social policies and public health measures in the small county of Bedford, within the national context, 1904-38. No other such study exists which covers these aspects; it will, therefore, fill a gap in the body of knowledge. At this time, national and imperial needs for a healthy British race were paramount in the minds of politicians and social reformers, particularly in the face of competition for industrial and military supremacy from other powers, including Germany and the United States of America. Certain key themes permeated this era: the changing functions of local and central government, the role of the state and voluntary sectors, and a medical profession divided between those employed in preventive medicine, and those in private practice. However, war, the preparation for war and its after effects have been found to be the most significant factors. George Newman (1870-1948), figures large, because he played a major part in public health initiatives, firstly, as part-time County Medical Officer of Health to Bedfordshire County Council (1900-07), and then at central government level, as Chief Medical Officer of the Board of Education (1907-35), and of the Ministry of Health (1919-35). Two methodological tools were used in this thesis. Historical research was carried out using, mainly, primary source material, and an empirical study was undertaken using a descriptive case study approach. These methods enabled the collection of quantitative and qualitative data and helped to determine both the final content, and the form in which the research was presented. Chapter 1, the Introduction, provides a background to the key figures and themes discussed and describes the intra-county differences in Bedfordshire. Chapter 2 concerns infant mortality, as it is an indicator of the health ofthe whole community. Chapter 3 describes the health of school children, because the Government was particularly anxious about their condition, as they would be needed for industrial and imperial expansion, and in the event of war. Chapter 4 concerns the welfare of children. It provides examples of how the state and voluntary sectors strove to preserve child life, despite problems such as orphanhood and cruelty, and yet still attempted to meet the needs of the British Empire for labour. Chapter 5 discusses women's health, as it was relatively neglected by central government in this period. It takes the form of a case study and makes use of oral testimony from a cohort of 84 women who lived in Bedfordshire in the inter-war years. Chapter 6, the conclusion, examines the effect of war, the role played by the voluntary and state sectors, and the divided medical profession. It also considers the extent to which Bedfordshire led, or lagged behind national social policies and public health measures, and the progress made towards a healthier nation until 1938, the last full year of peace in Europe before the outbreak of World War II.

Recently, subjective wellbeing, or more popularly, happiness and life satisfaction, have received growing interest from social scientists, policy makers, and the public alike. This thesis applies Wellbeing, Self-determination, and Social Cognitive theories, and investigates the role of subjective wellbeing for obesity. The main methodology is multivariate regression with ordinary least square, Logit, and two-stage least square estimators. The data are from the Canadian Community Health Survey, 2010. Results show that subjective wellbeing has negative, independent impact on body mass index (BMI) and on the probability of being obese after controlling for the conventionally studied determinants of obesity like age, gender, income, and education. The study contributes to the literature on obesity and suggests possible policy interventions on obesity from the perspective of subjective wellbeing.

Thesis (Ph. D.)--University of New South Wales, 2002. / Also available online.

Thesis (Ph.D.)--University of Adelaide, School of Social Sciences, Discipline of Gender and Labour Studies, 2004. / "January 2004" Includes bibliographical references (leaves 297-313).

Thesis (Ph.D.)--Australian National University, 2003.

Thesis (M.Soc.Sc.)--University of Hong Kong, 1983. / Also available in print.