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Strengthening medical specialisation policy in low-income and middle-income countries

The availability of medical specialists has accelerated in low-income and middle-income countries (LMICs), driven by factors including epidemiological and demographic shifts, doctors’ preferences for postgraduate training, income growth and medical tourism. Yet, despite some policy efforts to increa...

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Autores principales: Sriram, Veena, Bennett, Sara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7042575/
https://www.ncbi.nlm.nih.gov/pubmed/32133192
http://dx.doi.org/10.1136/bmjgh-2019-002053
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author Sriram, Veena
Bennett, Sara
author_facet Sriram, Veena
Bennett, Sara
author_sort Sriram, Veena
collection PubMed
description The availability of medical specialists has accelerated in low-income and middle-income countries (LMICs), driven by factors including epidemiological and demographic shifts, doctors’ preferences for postgraduate training, income growth and medical tourism. Yet, despite some policy efforts to increase access to specialists in rural health facilities and improve referral systems, many policy questions are still underaddressed or unaddressed in LMIC health sectors, including in the context of universal health coverage. Engaging with issues of specialisation may appear to be of secondary importance, compared with arguably more pressing concerns regarding primary care and the social determinants of health. However, we believe this to be a false choice. Policy at the intersection of essential health services and medical specialties is central to issues of access and equity, and failure to formulate policy in this regard may have adverse ramifications for the entire system. In this article, we describe three critical policy questions on medical specialties and health systems with the aim of provoking further analysis, discussion and policy formulation: (1) What types, and how many specialists to train? (2) How to link specialists’ production and deployment to health systems strengthening and population health? (3) How to develop and strengthen institutions to steer specialisation policy? We posit that further analysis, discussion and policy formulation addressing these questions presents an important opportunity to explicitly determine and strengthen the linkages between specialists, health systems and health equity.
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spelling pubmed-70425752020-03-04 Strengthening medical specialisation policy in low-income and middle-income countries Sriram, Veena Bennett, Sara BMJ Glob Health Analysis The availability of medical specialists has accelerated in low-income and middle-income countries (LMICs), driven by factors including epidemiological and demographic shifts, doctors’ preferences for postgraduate training, income growth and medical tourism. Yet, despite some policy efforts to increase access to specialists in rural health facilities and improve referral systems, many policy questions are still underaddressed or unaddressed in LMIC health sectors, including in the context of universal health coverage. Engaging with issues of specialisation may appear to be of secondary importance, compared with arguably more pressing concerns regarding primary care and the social determinants of health. However, we believe this to be a false choice. Policy at the intersection of essential health services and medical specialties is central to issues of access and equity, and failure to formulate policy in this regard may have adverse ramifications for the entire system. In this article, we describe three critical policy questions on medical specialties and health systems with the aim of provoking further analysis, discussion and policy formulation: (1) What types, and how many specialists to train? (2) How to link specialists’ production and deployment to health systems strengthening and population health? (3) How to develop and strengthen institutions to steer specialisation policy? We posit that further analysis, discussion and policy formulation addressing these questions presents an important opportunity to explicitly determine and strengthen the linkages between specialists, health systems and health equity. BMJ Publishing Group 2020-02-11 /pmc/articles/PMC7042575/ /pubmed/32133192 http://dx.doi.org/10.1136/bmjgh-2019-002053 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Analysis
Sriram, Veena
Bennett, Sara
Strengthening medical specialisation policy in low-income and middle-income countries
title Strengthening medical specialisation policy in low-income and middle-income countries
title_full Strengthening medical specialisation policy in low-income and middle-income countries
title_fullStr Strengthening medical specialisation policy in low-income and middle-income countries
title_full_unstemmed Strengthening medical specialisation policy in low-income and middle-income countries
title_short Strengthening medical specialisation policy in low-income and middle-income countries
title_sort strengthening medical specialisation policy in low-income and middle-income countries
topic Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7042575/
https://www.ncbi.nlm.nih.gov/pubmed/32133192
http://dx.doi.org/10.1136/bmjgh-2019-002053
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