The overall objectives are as follows:
* To increase understanding of the impact on efficiency and equity of reform of selected policies relating to the financing, organization and structure of health care systems.
* To produce information that will support the process of reform of health care systems in the Caribbean .
* To strengthen the capacity of the Faculty of Medical Sciences, St. Augustine, Trinidad and the Faculty of Medical Sciences, Anton de Kom University of Suriname, to do research relevant to health care systems.
* To foster closer long-term collaboration in health care system operational research between European health research institutions and the Faculties of Medical Sciences in Trinidad and Suriname.
Increased understanding of the impact on efficiency and equity of those policies relating to the financing, organisation and structure of health care systems relative to the contextual development of the system. It is expected that information will be produced to support the process of reform of health care systems in the Caribbean.
The capacity of the Faculties of Medical Sciences, St. Augustine, Trinidad and Anton de Kom University of Suriname will be strengthened to do research relevant to health care systems, and long term collaboration in health care operational research between the European research institutions and the Caribbean/South American partners will be established.
The project is divided into two phases:
This phase involves study of influences on the historical development of health services in order to understand the nature of the health care system inherited at independence (or similar period), subsequent changes, and the current situation. Investigation will focus on demographic, epidemiological, political, social, economic and legislative influences, and trends will be determined. Selected aspects of the health systems will be reviewed covering areas including sources of finance, organization of public sector health services, structure of health services in relation to levels of care, and the public/private provider balance. Two main conceptual frameworks will be drawn on:
i) categories of health system
ii) process of policy formulation and analysis
Where documentation of crucial decision-making and influences is not available, interviews will be held with those who were part of the decision-making process of that period.
Three policy areas will be evaluated in depth in this phase as follows:
a) the new approach to public sector management (Trinidad & Tobago)
b) the adoption of principles of social insurance as the basis for funding the
health care system (Suriname & Martinique)
c) government's approach to the private sector (The Bahamas)
The results of these studies will be compared with the results of Phase 1 for each country/island. Policies will be evaluated according to the criteria including allocative efficiency, technical efficiency, equity, accountability, acceptability, and affordability.
Funding SchemeCSC - Cost-sharing contracts
WC1E 7HT London