Universal health coverage from multiple perspectives: a synthesis of conceptual literature and global debates

Background: There is an emerging global consensus on the importance of universal health coverage (UHC), but no unanimity on the conceptual definition and scope of UHC, whether UHC is achievable or not, how to move towards it, common indicators for measuring its progress, and its long-term sustainability. This has resulted in various interpretations of the concept, emanating from different disciplinary perspectives. This paper discusses the various dimensions of UHC emerging from these interpretations and argues for the need to pay attention to the complex interactions across the various components of a health system in the pursuit of UHC as a legal human rights issue. Discussion: The literature presents UHC as a multi-dimensional concept, operationalized in terms of universal population coverage, universal financial protection, and universal access to quality health care, anchored on the basis of health care as an international legal obligation grounded in international human rights laws. As a legal concept, UHC implies the existence of a legal framework that mandates national governments to provide health care to all residents while compelling the international community to support poor nations in implementing this right. As a humanitarian social concept, UHC aims at achieving universal population coverage by enrolling all residents into health-related social security systems and securing equitable entitlements to the benefits from the health system for all. As a health economics concept, UHC guarantees financial protection by providing a shield against the catastrophic and impoverishing consequences of out-of-pocket expenditure, through the implementation of pooled prepaid financing systems. As a public health concept, UHC has attracted several controversies regarding which services should be covered: comprehensive services vs. minimum basic package, and priority disease-specific interventions vs. primary health care. Summary: As a multi-dimensional concept, grounded in international human rights laws, the move towards UHC in LMICs requires all states to effectively recognize the right to health in their national constitutions. It also requires a human rights-focused integrated approach to health service delivery that recognizes the health system as a complex phenomenon with interlinked functional units whose effective interaction are essential to reach the equilibrium called UHC

Pooling job physical exposure data from multiple independent studies in a consortium study of carpal tunnel syndrome

Pooling data from different epidemiological studies of musculoskeletal disorders (MSDs) is necessary to improve statistical power and to more precisely quantify exposure–response relationships for MSDs. The pooling process is difficult and time-consuming, and small methodological differences could lead to different exposure–response relationships. A subcommittee of a six-study research consortium studying carpal tunnel syndrome: (i) visited each study site, (ii) documented methods used to collect physical exposure data and (iii) determined compatibility of exposure variables across studies. Certain measures of force, frequency of exertion and duty cycle were collected by all studies and were largely compatible. A portion of studies had detailed data to investigate simultaneous combinations of force, frequency and duration of exertions. Limited compatibility was found for hand/wrist posture. Only two studies could calculate compatible Strain Index scores, but Threshold Limit Value for Hand Activity Level could be determined for all studies. Challenges of pooling data, resources required and recommendations for future researchers are discussed

Financing Universal Coverage in Malaysia: a case study

One of the challenges to maintain an agenda for universal coverage and equitable health system is to develop effective structuring and management of health financing. Global experiences with different systems of health financing suggests that a strong public role in health financing is essential for health systems to protect the poor and health systems with the strongest state role are likely the more equitable and achieve better aggregate health outcomes. Using Malaysia as a case study, this paper seeks to evaluate the progress and capacity of a middle income country in terms of health financing for universal coverage, and also to highlight some of the key underlying health systems challenges

A method to design job rotation schedules to prevent work-related musculoskeletal disorders in repetitive work

This is an Accepted Manuscript of an article published by Taylor & Francis Group in International Journal of Production Research in 2012, available online: http://www.tandfonline.com/10.1080/00207543.2011.653452.Job rotation is an organisational strategy widely used in human-based production lines with the aim of preventing work-related musculoskeletal disorders (WMSDs). These work environments are characterised by the presence of a high repetition of movements, which is a major risk factor associated with WMSDs. This article presents a genetic algorithm to obtain rotation schedules aimed at preventing WMSDs in such environments. To do this, it combines the effectiveness of genetic algorithms optimisation with the ability to evaluate the presence of risk by repeated movements by following the OCRA ergonomic assessment method. The proposed algorithm can design solutions in which workers will switch jobs with high repeatability of movements with other less demanding jobs that support their recovery. In addition, these solutions are able to diversify the tasks performed by workers during the day, consider their disabilities and comply with restrictions arising from the work organisation.The authors wish to thank the Universitat Politecnica de Valencia which supported this research through its Program for the Support of Research and Development 2009 and its financing through the project PAID-06-09/2902.Asensio Cuesta, S.; Diego-Mas, JA.; Cremades Oliver, L.; González-Cruz, M. (2012). A method to design job rotation schedules to prevent work-related musculoskeletal disorders in repetitive work. International Journal of Production Research. 50(24):7467-7478. https://doi.org/10.1080/00207543.2011.653452S74677478502

PLATFORM: Study of the integration of new nanomaterials in a current processes of manufacture with prepreg materials in aeronautics

PLATFORM appear for the need to improve non-intrinsic properties of composite materials, principally its mechanical and electrical properties. The main objective of the project is to analyze the possibility of introducing three new materials in development into the current manufacturing processes, improving the properties of the raw material, more concrectly prepreg unidirectional carbon fibre with epoxy resin. Several material developments are made with carbon nanotubes in three different formats: buckypapers, thermoplastic doped veils and CTN treated prepreg. The implementation of each materials has been studied in current infusion processes, more concretely manufacturing with prepregs and cure in an autoclave. The studied possibilities are: buckypapers incorporated and doped veils embedded in prepreg laminates or full manufacturing with treated prepreg. The obtained results at the 2nd year of the project are satisfactory, but it´s necessary to optimize the materials to automate the manufacturing and improve the final properties

Use of a Computerized Decision Support System for Primary and Secondary Prevention of Work-Related MSD Disability

The present study evaluates the effectiveness of a decision support system used to evaluate and control physical job stresses and prevent re-injury of workers who have experienced or are concerned about work-related musculoskeletal disorders. The software program is a database that stores detailed job information such as standardized work data, videos, and upper-extremity physical stress ratings for over 400 jobs in the plant. Additionally, the database users were able to record comments about the jobs and related control issues. The researchers investigated the utility and effectiveness of the software by analyzing its use over a 20-month period. Of the 197 comments entered by the users, 25% pertained to primary prevention, 75% pertained to secondary prevention, and 94 comments (47.7%) described ergonomic interventions. Use of the software tool improved primary and secondary prevention by improving the quality and efficiency of the ergonomic job analysis process.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45017/1/10926_2005_Article_5939.pd