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Article
Publication date: 6 November 2007

Tolib N. Mirzoev, Andrew T. Green and James N. Newell

The purpose of this paper is to provide an up‐to‐date overview of Tajikistan's health system, focusing on the main factors affecting health systems development. The wider…

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Abstract

Purpose

The purpose of this paper is to provide an up‐to‐date overview of Tajikistan's health system, focusing on the main factors affecting health systems development. The wider contextual environment is to be explored, focusing on political, social and economic issues. Different elements of the health system including health policy, governance, service delivery, human resources and health financing are reviewed in the light of their development over the past decade.

Design/methodology/approach

The paper shows that the Republic of Tajikistan is in transition. Formerly one of the most neglected republics within the USSR, the country became independent in 1990 and faced the civil conflict shortly thereafter. In the last few years there have been major public sector reforms with health reforms formally launched in the late 1990s. Little information about current Tajikistan is widely available.

Findings

The paper finds that the progress of health reforms in Tajikistan has been relatively slow compared with neighbouring Kazakhstan and Kyrgyzstan. This is largely due to the effects of civil war in the mid‐1990s and significant out‐migration of qualified experts, but it can also be attributed to an inability of central government to adequately adapt to the requirements of transition.

Originality/value

The paper shows that many problems are still to be overcome by the health system, ranging from operational issues related to service delivery to strategic issues such as formulating an explicit privatisation policy, reducing fragmentation of, and aligning, external aid. However, some recent developments, such as adoption of a country health reform conception, a health financing strategy, and willingness of central government to improve coordination, suggest that improvements are possible.

Details

Journal of Health Organization and Management, vol. 21 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 25 July 2020

Benjamin Sunday Uzochukwu, Chinyere Cecilia Okeke, Joyce Ogwezi, Benedict Emunemu, Felicia Onibon, Bassey Ebenso, Tolib Mirzoev and Ghazala Mir

The importance of social exclusion and the disadvantage experienced by many minority ethnic and religious populations are rooted in SDG 10. To address this exclusion effectively…

Abstract

Purpose

The importance of social exclusion and the disadvantage experienced by many minority ethnic and religious populations are rooted in SDG 10. To address this exclusion effectively it is important to understand their key drivers. This paper aimed to establish the key drivers of exclusion and their outcomes in Nigeria.

Design/methodology/approach

The methods involved a scoping review of literature and stakeholder workshops that focused on drivers of social exclusion of religious and ethnic minorities in public institutions.

Findings

At the macro level, the drivers include ineffective centralized federal State, competition for resources and power among groups, geographic developmental divide and socio-cultural/religious issues. At the meso-level are institutional rules and competition for resources, stereotypes and misconceptions, barriers to access and service provision. At the micro-level are socio-economic status and health-seeking behaviour. The perceived impact of social exclusion included increasing illiteracy, lack of employment, deteriorating health care services, increased social vices, communal clashes and insurgencies and vulnerability to exploitation and humiliation. These drivers must be taken into consideration in the development of interventions for preventing or reducing social exclusion of ethnic and religious minorities from public services.

Originality/value

This is a case of co-production by all the stakeholders and a novel way for the identification of drivers of social exclusion in public services in Nigeria. It is the first step towards solving the problem of exclusion and has implications for the achievement of SDG 10 in Nigeria.

Details

International Journal of Sociology and Social Policy, vol. 41 no. 5/6
Type: Research Article
ISSN: 0144-333X

Keywords

Article
Publication date: 22 February 2022

Kayla Halsey, Salameh Alarood, Mohammed Nawaiseh and Ghazala Mir

Refugees commonly face inequitable access to health care services in their host country. This study aimed to identify factors influence refugee access to health services and to…

Abstract

Purpose

Refugees commonly face inequitable access to health care services in their host country. This study aimed to identify factors influence refugee access to health services and to assess perceptions of barriers to health care for different refugee groups in Jordan.

Design/methodology/approach

In-depth interviews were combined with document analysis and analyzed using thematic and framework methods.

Findings

Findings highlighted inequitable access to health services between different refugee groups. Unlike Palestinian refugees from the West Bank, Palestinian refugees from Gaza faced financial barriers to access health care as a result of citizenship status, which affected their health insurance, referrals for health care and legal right to work. Syrian refugees similarly lacked Jordanian citizenship and health insurance and mainly depended on UNHCR for health services, though some were able to acquire work permits and pay for private care.

Originality/value

This study demonstrates a need for politically and economically appropriate policies to minimize the disparity of health care access among these refugee groups.

Details

International Journal of Migration, Health and Social Care, vol. 18 no. 1
Type: Research Article
ISSN: 1747-9894

Keywords

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