Health system challenges of cardiovascular disease and diabetes in four Eastern Mediterranean countries

This paper presents evidence from research into health system challenges of cardiovascular disease (CVD) and diabetes in four Eastern Mediterranean countries: the occupied Palestinian territory, Syria, Tunisia and Turkey. We address two questions. How has the health system in each country been conce...

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Bibliographic Details
Published in:Global public health 2013-08, Vol.8 (8), p.875-889
Main Authors: Phillimore, Peter, Zaman, Shahaduz, Ahmad, Balsam, Shoaibi, Azza, Khatib, Rasha, Khatib, Rana, Husseini, Abdullatif, Fouad, Fouad, Elias, Madonna, Maziak, Wasim, Tlili, Faten, Tinsa, Francine, Ben Romdhane, Habiba, Kılıç, Bülent, Kalaça, Sibel, Ünal, Belgin, Critchley, Julia
Format: Article
Language:English
Subjects:
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - therapy
Clinics
Comparative analysis
Delivery of Health Care - organization & administration
Diabetes
Diabetes Mellitus - epidemiology
Diabetes Mellitus - therapy
Diseases
Eastern Mediterranean
Finance
Health care
Health care policy
Health Policy
Heart disease
Humans
Information systems
Investments
Israel - epidemiology
Middle East
NCD
Neoliberalism
Palestinians
Public health
Qualitative Research
Syria
Syria - epidemiology
Tunisia
Tunisia - epidemiology
Turkey
Turkey - epidemiology
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Summary:This paper presents evidence from research into health system challenges of cardiovascular disease (CVD) and diabetes in four Eastern Mediterranean countries: the occupied Palestinian territory, Syria, Tunisia and Turkey. We address two questions. How has the health system in each country been conceptualised and organised to manage the provision of care for those with CVD or diabetes? And what were key concerns about the institutional ability to address this challenge? Research took place from 2009 to 2010, shortly before the political upheavals in the region, and notably in Syria and Tunisia. Data collection involved a review of key documents, interviews with key informants and brief data collection in clinics. In analysing the data, we adopted the analytical schema proposed by Walt and Gilson, distinguishing content, actors, context and process. Key findings from each country highlighted concerns about fragmented provision and a lack of coordination. Specific concerns included: the lack of patient referral pathways, functioning health information systems and investment in staff. Regarding issues underlying these 'visible' problems in managing these diseases, we highlight implications of the wider systemic pressure for reform of health-sector finance in each country, based on neoliberal models.
ISSN:1744-1692
1744-1706
DOI:10.1080/17441692.2013.830756