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Localization of health systems in low- and middle-income countries in response to long-term increases in energy prices

External challenges to health systems, such as those caused by global economic, social and environmental changes, have received little attention in recent debates on health systems’ performance in low-and middle-income countries (LMICs). One such challenge in coming years will be increasing prices f...

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Autores principales: Dalglish, Sarah L, Poulsen, Melissa N, Winch, Peter J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3826843/
https://www.ncbi.nlm.nih.gov/pubmed/24199690
http://dx.doi.org/10.1186/1744-8603-9-56
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author Dalglish, Sarah L
Poulsen, Melissa N
Winch, Peter J
author_facet Dalglish, Sarah L
Poulsen, Melissa N
Winch, Peter J
author_sort Dalglish, Sarah L
collection PubMed
description External challenges to health systems, such as those caused by global economic, social and environmental changes, have received little attention in recent debates on health systems’ performance in low-and middle-income countries (LMICs). One such challenge in coming years will be increasing prices for petroleum-based products as production from conventional petroleum reserves peaks and demand steadily increases in rapidly-growing LMICs. Health systems are significant consumers of fossil fuels in the form of petroleum-based medical supplies; transportation of goods, personnel and patients; and fuel for lighting, heating, cooling and medical equipment. Long-term increases in petroleum prices in the global market will have potentially devastating effects on health sectors in LMICs who already struggle to deliver services to remote parts of their catchment areas. We propose the concept of “localization,” originating in the environmental sustainability literature, as one element of response to these challenges. Localization assigns people at the local level a greater role in the production of goods and services, thereby decreasing reliance on fossil fuels and other external inputs. Effective localization will require changes to governance structures within the health sector in LMICs, empowering local communities to participate in their own health in ways that have remained elusive since this goal was first put forth in the Alma-Ata Declaration on Primary Health Care in 1978. Experiences with decentralization policies in the decades following Alma-Ata offer lessons on defining roles and responsibilities, building capacity at the local level, and designing appropriate policies to target inequities, all of which can guide health systems to adapt to a changing environmental and energy landscape.
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spelling pubmed-38268432013-11-14 Localization of health systems in low- and middle-income countries in response to long-term increases in energy prices Dalglish, Sarah L Poulsen, Melissa N Winch, Peter J Global Health Debate External challenges to health systems, such as those caused by global economic, social and environmental changes, have received little attention in recent debates on health systems’ performance in low-and middle-income countries (LMICs). One such challenge in coming years will be increasing prices for petroleum-based products as production from conventional petroleum reserves peaks and demand steadily increases in rapidly-growing LMICs. Health systems are significant consumers of fossil fuels in the form of petroleum-based medical supplies; transportation of goods, personnel and patients; and fuel for lighting, heating, cooling and medical equipment. Long-term increases in petroleum prices in the global market will have potentially devastating effects on health sectors in LMICs who already struggle to deliver services to remote parts of their catchment areas. We propose the concept of “localization,” originating in the environmental sustainability literature, as one element of response to these challenges. Localization assigns people at the local level a greater role in the production of goods and services, thereby decreasing reliance on fossil fuels and other external inputs. Effective localization will require changes to governance structures within the health sector in LMICs, empowering local communities to participate in their own health in ways that have remained elusive since this goal was first put forth in the Alma-Ata Declaration on Primary Health Care in 1978. Experiences with decentralization policies in the decades following Alma-Ata offer lessons on defining roles and responsibilities, building capacity at the local level, and designing appropriate policies to target inequities, all of which can guide health systems to adapt to a changing environmental and energy landscape. BioMed Central 2013-11-07 /pmc/articles/PMC3826843/ /pubmed/24199690 http://dx.doi.org/10.1186/1744-8603-9-56 Text en Copyright © 2013 Dalglish et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Debate
Dalglish, Sarah L
Poulsen, Melissa N
Winch, Peter J
Localization of health systems in low- and middle-income countries in response to long-term increases in energy prices
title Localization of health systems in low- and middle-income countries in response to long-term increases in energy prices
title_full Localization of health systems in low- and middle-income countries in response to long-term increases in energy prices
title_fullStr Localization of health systems in low- and middle-income countries in response to long-term increases in energy prices
title_full_unstemmed Localization of health systems in low- and middle-income countries in response to long-term increases in energy prices
title_short Localization of health systems in low- and middle-income countries in response to long-term increases in energy prices
title_sort localization of health systems in low- and middle-income countries in response to long-term increases in energy prices
topic Debate
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3826843/
https://www.ncbi.nlm.nih.gov/pubmed/24199690
http://dx.doi.org/10.1186/1744-8603-9-56
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