This thesis explores a three month period that I spent abroad working in medical clinics and hospitals in Ecuador. My work was conducted in three distinct areas: the urban landscape of Quito, Ecuador’s capital; Puyo, a small town bordering the Amazonian rainforest; and a small community located in the heart...
One in four Ecuadorians do not have access to health services; while more than two-thirds have no health insurance and insufficient resources to pay for the health care services they might require. The following three studies examined utilization of health care services using Andersen’s Health Care Utilization Behavior Theory. Secondary...
After decades of expert-based modernization efforts that have had profound negative impacts on human and environmental health, Ecuador is currently pursuing a rights-based, participatory development paradigm known as sumak kawsay or "the good life". Despite its promises of inclusion and interculturality, this approach continues to rely on highly trained specialists,...
This study aims to identify conceptions of the body, as well as "rational" treatment
among primary care practitioners (PCPs) and emergency medicine practitioners (EMPs)
dealing with managed care plans. I conducted ethnographic study throughout 1996, and
interviewed six PCPs and four EMPs. In the course of my interviews, I discovered...
Several states, including Oregon, Massachusetts and California, have been the focus of major health reform efforts in recent years. Oregon utilized a citizen-led commission to generate policy recommendations that led to the enactment of health reform legislation in 2009. This commission helped to create momentum and provide political cover for...
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The Advocacy Coalition Framework and Health Care Reform
En mayo de este año, la Revista Panamericana de Salud Pública dedicó un número especial a promover el proceso más reciente de reforma de salud en Ecuador como un caso exitoso en la región. En el artículo editorial, la directora de la Organización Panamericana de la Salud (OPS), Carissa Etienne,...
Cultural competence is a topic that concerns social scientists and medical anthropologists who pay attention to demographic changes and health disparities. This study demonstrates practical approaches to developing cultural competence in medical education by using factors from the social environment to develop protocols for action. With current concerns in domestic...
Introduction: Management of complex systems is facilitated through effective information systems that provide real-time data to decision makers. For example, instrument panels in airplanes ensure that pilots have well-designed feedback concerning the status of mission-critical variables. Problem: While pilots have dashboards for feedback and communication, healthcare executives may be unaware...
Health systems financing aims at providing adequate services, ensuring sufficient providers’ incentives, and protecting individuals and families from financial catastrophe. Health services are financed through government funding, taxation, out-of-pocket payments, insurance, donations and voluntary aid. Low- income countries mostly rely on out-of-pocket payments. In South East Asia region, the latter...
Children with developmental disabilities (DD), particularly autism spectrum disorder (ASD), may use complementary health approaches (CHA), including some modalities that can be unsafe, inefficacious, and/or costly. Still, the prevalence of CHA use among US children with DD is not known and their reasons for use are not well understood. By...