Typescript (photocopy). / Digitized by Kansas Correctional Industries

China is moving towards a market economy. The greater use of market forces has made China richer, accelerated modernisation and increased productive efficiency but has created new problems, including, in the health sector, problems of inequity and allocative inefficiency. From 1997, the Chinese government committed to a national policy of regional health planning (RHP), as part of a broader commitment to harmonising social and economic development. However, RHP has been slow to impact on the equity and efficiency problems in health care. Planning requires information; better health decision-making requires better health information. Information systems constitute a resource that is vital for the health planning and the management of the health system. Properly developed, managed and used, health information systems are a highly cost-effective resource for the nation and its regions. Bureaucratic resistance, one of critical reasons is that regional health planners gained insufficient support from information system. Health information needs to adopt into the new way of government health management. The objective of the study is to contribute to the development of China�s health information system (HIS) over the next 5-10 years, in particular to suggest how provincial health information systems could be made more useful as a basis for RHP. The existing HIS is examined in relation to its support for and relevance to RHP, including policy framework, institutional structures and resources, networks and relationships, data collection, analysis, quality and accessibility of information as well as the use of information in support of health planning. Data sources include key informant interviews, a questionnaire survey and various policy documents. Qualitative (questionnaire survey on provincial HIS) and quantitative (key informant interviews) approaches are used in this study. Document analysis is also conducted. The research examines information for planning within the macro and historical context of health planning in China, in particular having regard to the impacts and implications of the transition to a market economy. It is evident that the implementation of RHP has been retarded by poor performance of information system, particularly at the provincial level. However, the implementation of RHP has also been complicated by fragmented administrative hierarchies, weak implementation mechanisms and contradictions between different policies, for example, between improved planning and the encouragement of market forces in health care. To support RHP which is needs based, has a focus on improving allocative efficiency and is adapted to the new market development will require new information products and supports including infrastructure reform and capacity development. Provincial HIS needs to move from being data generators and transmitters to becoming information producers and providers. Health planning has moved to greater use of population-based benchmark and demand-side control. Therefore, information products should be widened from supply side data collection (in particular assets and resources) to include demand-side collection and analysis (including utilisation patterns and community surveys of opinion and experience). The interaction between users (the planners) and producers (the HIS) should be strengthened and regional networks of information producers and planners should be established.

This thesis examines the effect of absenteeism on education quality for primary-aged public school students in the Department of Loreto, Province of Maynas, situated in the Amazonian region of north-eastern Peru. The thesis also examines the underlying reasons for absenteeism, with a focus on the contribution of childhood morbidity and socio-economic and environmental context to absenteeism, using both gender- and grade-based analyses of student level absenteeism data collected from a sample of schools in the study area. A five-component model with multiple individual indicators measuring each component of education systems defines the concept of education quality as it relates to the analysis in the thesis. The model has been demonstrated in previous research to be effective in explaining variations in education quality in Peru and elsewhere. However, the model has not been applied to this important yet under-researched area of education assessment, namely student absenteeism (at the student and school level) and its effect on education quality. In addition, spatial variations in absenteeism, based on the geographic distribution of the schools over the study area, are evaluated. This analysis allows spatial regularities or spatial randomness to be established for both absenteeism and education quality in the study area. Identifying spatial clustering of public primary schools where a high rate of student absenteeism contributes significantly to explaining overall low levels of education quality can provide education policy planners and decision-makers with insights into causal processes that need to be addressed through planned interventions in the education system.

This thesis examines the effect of absenteeism on education quality for primary-aged public school students in the Department of Loreto, Province of Maynas, situated in the Amazonian region of north-eastern Peru. The thesis also examines the underlying reasons for absenteeism, with a focus on the contribution of childhood morbidity and socio-economic and environmental context to absenteeism, using both gender- and grade-based analyses of student level absenteeism data collected from a sample of schools in the study area. A five-component model with multiple individual indicators measuring each component of education systems defines the concept of education quality as it relates to the analysis in the thesis. The model has been demonstrated in previous research to be effective in explaining variations in education quality in Peru and elsewhere. However, the model has not been applied to this important yet under-researched area of education assessment, namely student absenteeism (at the student and school level) and its effect on education quality. In addition, spatial variations in absenteeism, based on the geographic distribution of the schools over the study area, are evaluated. This analysis allows spatial regularities or spatial randomness to be established for both absenteeism and education quality in the study area. Identifying spatial clustering of public primary schools where a high rate of student absenteeism contributes significantly to explaining overall low levels of education quality can provide education policy planners and decision-makers with insights into causal processes that need to be addressed through planned interventions in the education system.

This thesis explores the relevance of international law in the multilateral protection and promotion of public health in a world sharply divided by poverty and underdevelopment. In this endeavour, the thesis predominantly uses the concept of "mutual vulnerability" to discuss the globalisation of diseases and health hazards in the emergent global neighbourhood. Because pathogens do not respect geo-political boundaries, this thesis argues that the world has become one single germ pool where there is no health sanctuary. The concept of mutual vulnerability postulates that the irrelevance or obsolescence of national boundaries to microbial threats has created the capability to immerse all of humanity in a single microbial sea. It follows, therefore, that neither protectionism nor isolationism offers any effective defences against advancing microbial forces. As a result, the thesis argues that contemporary multilateral health initiatives should be driven primarily by enlightened self-interest as opposed to parochial protectionist policy. This study is primarily situated within the discipline of international law. Nonetheless, it draws on the social sciences in its analysis of traditional medicine in Africa. It also makes overtures to medical historians in its discussion of the attitudes of societies to diseases and to the evolution of public health diplomacy, to international relations in its analysis of international regime theories, and to a number of other disciplines interested in the phenomenon of globalisation. This interdisciplinary framework for analysis offers a holistic approach to public health policy-making and scholarship to counter the segmented approaches of the present era. Thus, this thesis is concerned with four related projects. First, it explores the relevance of legal interventions in the promotion and protection of public health. If health is a public good, legal interventions are indispensable intermediate strategies to deliver the final dividends of good health to the vulnerable and the poor in all societies. Second, it explores multicultural approaches to health promotion and protection and argues for a humane health order based on multicultural inclusiveness and multi-stakeholder participation in health-policy making. Using African traditional malaria therapies as a case study, the thesis urges an animation of transnational civil society networks to evolve a humane health order, one that fulfils the desired vision of harmony and fairness. Third, it makes an argument for increased collaboration among lawyers, epidemiologists and scholars of other disciplines related to public health. Using the tenets of health promotion and primary health care, the thesis urges an inter-disciplinary dialogue to facilitate the needed "epidemiological transition" across societies, especially in the developing world. Fourth, the thesis makes modest proposals towards the reduction of unequal disease burdens within and among nation-states. The thesis articulates these proposals genetically under the rubric of communitarian globalism, a paradigm that strives to meet the lofty ideals of the "law of humanity". In sum, it projects a humane world where all of humanity is inexorably tied in a global compact, where the health of one person rises and falls with the health of every other person, and where every country sees the health problems of other countries as its own. Arduous as these tasks may be, they are achievable only if damaged trust of past decades is rebuilt. Because the Westphalian sovereign states lack the full capacity to exhaustively pursue all the dynamics of communitarian globalism, multilateral governance structures must necessarily extend to both state and non-state actors. In this quest, the thesis concludes, international law - with its bold claims to universal protection of human rights and the enhancement of human dignity - is indispensable as a mechanism for reconstructing the public health trust in the relations of nations and of peoples.

Typescript. / Bibliography: leaves [247]-255. / Microfilm. / Photocopy. / xi, 255 leaves, bound ill. 29 cm

"While consumer participation is the focus of 21st century health policy, little is known about this concept from the perspectives of people who require acute hospital services. [...]This project set out to explore older people's perspective of participating in their care. Adopting critical ethnographic method, field work included observation of the inpatient experience. Following discharge home people were interviewed about their experiences including what helped and what hindered participation in their care. Similarly nurses involved in [...] a hospital experience were invited to be involved in individual and focus group discussions aimed at defining how they believed they facilitated people to participate as well as barriers that prevent this style of care." / Doctor of Philosophy

It is well documented that rural and remote Australian residents have poorer access to medical services than their counterparts in capital cities. According to the Australian Institute of Health and Welfare in 1998 there were 75.3 vocationally registered general practitioners per 100,000 population in rural and remote areas, compared with 103.0 per 100,000 in metropolitan areas. In 1998 28.7% of the Australian population lived in rural and remote areas, so a substantial proportion of the Australian population is adversely affected by the unequal distribution of general practitioners. Australian country communities highly regard the services of general practitioners and they continue to demand residential medical services. Demand is driven by need for access to health services, but also by the intimate inter-relationships between the general practice and community sustainability. For example, the general practice contributes to the viability of the local hospital which is often a major employer in the district. Consequently, many country communities strive to keep their general practice by contributing to practice infrastructure, providing governance, raising funds for medical equipment, and actively helping recruitment. / Thesis (PhDHealthSciences)--University of South Australia, 2004.

"While consumer participation is the focus of 21st century health policy, little is known about this concept from the perspectives of people who require acute hospital services. [...]This project set out to explore older people's perspective of participating in their care. Adopting critical ethnographic method, field work included observation of the inpatient experience. Following discharge home people were interviewed about their experiences including what helped and what hindered participation in their care. Similarly nurses involved in [...] a hospital experience were invited to be involved in individual and focus group discussions aimed at defining how they believed they facilitated people to participate as well as barriers that prevent this style of care." / Doctor of Philosophy

China is moving towards a market economy. The greater use of market forces has made China richer, accelerated modernisation and increased productive efficiency but has created new problems, including, in the health sector, problems of inequity and allocative inefficiency. From 1997, the Chinese government committed to a national policy of regional health planning (RHP), as part of a broader commitment to harmonising social and economic development. However, RHP has been slow to impact on the equity and efficiency problems in health care. Planning requires information; better health decision-making requires better health information. Information systems constitute a resource that is vital for the health planning and the management of the health system. Properly developed, managed and used, health information systems are a highly cost-effective resource for the nation and its regions. Bureaucratic resistance, one of critical reasons is that regional health planners gained insufficient support from information system. Health information needs to adopt into the new way of government health management. The objective of the study is to contribute to the development of China�s health information system (HIS) over the next 5-10 years, in particular to suggest how provincial health information systems could be made more useful as a basis for RHP. The existing HIS is examined in relation to its support for and relevance to RHP, including policy framework, institutional structures and resources, networks and relationships, data collection, analysis, quality and accessibility of information as well as the use of information in support of health planning. Data sources include key informant interviews, a questionnaire survey and various policy documents. Qualitative (questionnaire survey on provincial HIS) and quantitative (key informant interviews) approaches are used in this study. Document analysis is also conducted. The research examines information for planning within the macro and historical context of health planning in China, in particular having regard to the impacts and implications of the transition to a market economy. It is evident that the implementation of RHP has been retarded by poor performance of information system, particularly at the provincial level. However, the implementation of RHP has also been complicated by fragmented administrative hierarchies, weak implementation mechanisms and contradictions between different policies, for example, between improved planning and the encouragement of market forces in health care. To support RHP which is needs based, has a focus on improving allocative efficiency and is adapted to the new market development will require new information products and supports including infrastructure reform and capacity development. Provincial HIS needs to move from being data generators and transmitters to becoming information producers and providers. Health planning has moved to greater use of population-based benchmark and demand-side control. Therefore, information products should be widened from supply side data collection (in particular assets and resources) to include demand-side collection and analysis (including utilisation patterns and community surveys of opinion and experience). The interaction between users (the planners) and producers (the HIS) should be strengthened and regional networks of information producers and planners should be established.