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- Micah, Angela E., et al.
(författare)
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Tracking development assistance for health and for COVID-19 : a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050
- 2021
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Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 398:10308, s. 1317-1343
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Forskningsöversikt (refereegranskat)abstract
- Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached $8. 8 trillion (95% uncertainty interval [UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this, $13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and $1.4 billion was repurposed from existing health projects. $3.1 billion (22.4%) of the funds focused on country-level coordination and $2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34.3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.
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| 2. |
- Currie, Margaret, et al.
(författare)
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Understandings and applications of rural community resilience amongst Scottish stakeholders : introducing dual discourses
- 2022
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Ingår i: Community Development. - : Routledge. - 1557-5330 .- 1944-7485.
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Tidskriftsartikel (refereegranskat)abstract
- This paper considers understandings and applications of community resilience deployed by multiple stakeholders in rural Scotland. By exploring what stakeholders think rural community resilience means in theory and practice, we enhance existing understandings of the concept. Scottish policy has shifted towards neoliberalism and community empowerment, with the Government encouraging communities to play a proactive role in enhancing their own resilience. For this to occur successfully, we argue that it is important to understand the perspectives of multiple stakeholders in how they conceptualize community resilience, identify what practical factors they believe enhance community resilience, and provide a greater understanding of the mechanisms through which community resilience can be delivered. Drawing on data collected from focus groups and in-depth, semi-structured interviews, we question what resilience means and what factors can facilitate it in practice. We find that by examining the perspectives of multiple stakeholders, dual discourses of resilience emerge: the emergency which reflects the policy focus on short-term damage reduction, and the everyday which reflects the desire for more long-term adaptive capacities developing in response to gradual change in rural communities. We conclude that the discourse which stakeholders predominantly align with will affect how they understand, adopt, and practice the concept.
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| 3. |
- Glass, Jayne, et al.
(författare)
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Translating community resilience theory into practice : A deliberative Delphi approach
- 2022
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Ingår i: Sociologia Ruralis. - : Wiley Blackwell. - 0038-0199 .- 1467-9523.
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Tidskriftsartikel (refereegranskat)abstract
- Despite the availability of important theoretical insights that could enhance the resilience of rural communities to complex challenges, there is a paucity of guidance on how to apply these insights in practice. This paper therefore presents and assesses a deliberative research process using the Delphi technique to elicit expert knowledge from 22 academics, community practitioners and policy makers working in roles related to community resilience delivery in rural Scotland. The participants co-produced an operational framework for community resilience, with support from researchers who facilitated the three-stage, interactive process. The methodology enabled participants to work together in an iterative and inclusive manner, culminating in the collective development of a conceptual framework consisting of eight resilience-enabling factors and corresponding criteria for monitoring change, which can be used to plan practical action and provide feedback to enable ongoing adaptation. The process also produced an in-depth understanding of participants’ perceptions of rural community resilience, identified key factors that enable or impede rural community resilience, analysed the potential to assess community resilience, and explored scale-related issues. The paper explores the implications of this framework for those working to make rural communities more resilient and reflects on the benefits and wider application of this type of research approach for developing shared understandings of complex concepts.
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| 4. |
- Currie, Mags, et al.
(författare)
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Understanding the response to Covid-19 : exploring options for a resilient social and economic recovery in Scotland’s rural and island communities
- 2021
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This research considered the impacts of Covid-19 on rural and island communities, how resiliently they have responded; and the most effective ways forward for their recovery. Our research approach involved: interviewing people in key rural sectors then producing a map to identify factors of resilience. This map was used to identify case study communities. Interviews were undertaken in these communities to understand local perspectives.Rural and island communities have been vulnerable to the impacts of Covid. Specific factors that have increased their vulnerability include reliance on limited employment sectors, being located far from centralised services (e.g. hospitals), limited digital connectivity; and an ageing population. Communities with a more resilient response had some or all of the following features: a strong sense of community; community organisations and local businesses that have been responsive to local needs; the existence of strategic partnerships between community organisations and the public/private sector; and good digital connectivity.Covid-19 has brought rural vulnerabilities into sharp focus and these vulnerabilities are often connected. Strategic and joined-up partnerships between community, public and private sector organisations will remain important, as well as novel and flexible funding mechanisms to enable place-based and context-specific responses.This research highlighted nine actions that would assist rural and island communities to thrive in the future. These include: 1. Building on existing and new partnerships and supporting anchor organisations 2. Capitalising on and rewarding community spirit 3. Encouraging and supporting young people to move to rural and island communities 4. Retaining and enhancing digital connectivity opportunities 5. Supporting adaptable local businesses 6. Strategic partnerships with deliver place-based solutions 7. Continue to support diversification of the rural economy 8. Enhancing the knowledge base on local-regional vulnerabilities 9. Retaining a flexible, targeted and responsive approach to financial support.
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