Rethinking health systems in the context of urbanisation: Challenges from four rapidly urbanising low-income and middle-income countries
This article was published in the BMJ Global Health [© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ and the definite version is available at: http://dx.doi.org/10.1136/bmjgh-2019-001501 The Journal's website is at: https://gh.bmj.com/content/4/3/e001501....
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2022
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| オンライン･アクセス: | http://hdl.handle.net/10361/16480 http://dx.doi.org/10.1136/bmjgh-2019-001501 |
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10361-164802022-03-27T21:01:28Z Rethinking health systems in the context of urbanisation: Challenges from four rapidly urbanising low-income and middle-income countries Elsey, Helen Agyepong, Irene Huque, Rumana Quayyem, Zahidul Baral, Sushil Ebenso, Bassey Kharel, Chandani Shawon, Riffat Ara Onwujekwe, Obinna Uzochukwu, Benjamin Nonvignon, Justice Aryeetey, Genevieve Cecilia Kane, Sumit Ensor, Tim Mirzoev, Tolib Brac James P. Grant School of Public Health Health Systems Urbanisation Low-income and Middle-income countries This article was published in the BMJ Global Health [© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ and the definite version is available at: http://dx.doi.org/10.1136/bmjgh-2019-001501 The Journal's website is at: https://gh.bmj.com/content/4/3/e001501.abstract The world is now predominantly urban; rapid and uncontrolled urbanisation continues across low-income and middle-income countries (LMICs). Health systems are struggling to respond to the challenges that urbanisation brings. While better-off urbanites can reap the benefits from the ‘urban advantage’, the poorest, particularly slum dwellers and the homeless, frequently experience worse health outcomes than their rural counterparts. In this position paper, we analyse the challenges urbanisation presents to health systems by drawing on examples from four LMICs: Nigeria, Ghana, Nepal and Bangladesh. Key challenges include: responding to the rising tide of noncommunicable diseases and to the wider determinants of health, strengthening urban health governance to enable multisectoral responses, provision of accessible, quality primary healthcare and prevention from a plurality of providers. We consider how these challenges necessitate a rethink of our conceptualisation of health systems. We propose an urban health systems model that focuses on: multisectoral approaches that look beyond the health sector to act on the determinants of health; accountability to, and engagement with, urban residents through participatory decision making; and responses that recognise the plurality of health service providers. Within this model, we explicitly recognise the role of data and evidence to act as glue holding together this complex system and allowing incremental progress in equitable improvement in the health of urban populations. Published 2022-03-27T09:21:50Z 2022-03-27T09:21:50Z 2019 2019-06-16 Journal Article Elsey, H., Agyepong, I., Huque, R., Quayyem, Z., Baral, S., Ebenso, B., . . . Mirzoev, T. (2019). Rethinking health systems in the context of urbanisation: Challenges from four rapidly urbanising low-income and middle-income countries. BMJ Global Health, 4(3) doi:10.1136/bmjgh-2019-001501 http://hdl.handle.net/10361/16480 http://dx.doi.org/10.1136/bmjgh-2019-001501 en_US https://gh.bmj.com/content/4/3/e001501.abstract BMJ Global Health application/pdf BMJ Journals |
| institution |
Brac University |
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Institutional Repository |
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en_US |
| topic |
Health Systems Urbanisation Low-income and Middle-income countries |
| spellingShingle |
Health Systems Urbanisation Low-income and Middle-income countries Elsey, Helen Agyepong, Irene Huque, Rumana Quayyem, Zahidul Baral, Sushil Ebenso, Bassey Kharel, Chandani Shawon, Riffat Ara Onwujekwe, Obinna Uzochukwu, Benjamin Nonvignon, Justice Aryeetey, Genevieve Cecilia Kane, Sumit Ensor, Tim Mirzoev, Tolib Rethinking health systems in the context of urbanisation: Challenges from four rapidly urbanising low-income and middle-income countries |
| description |
This article was published in the BMJ Global Health [© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ and the definite version is available at: http://dx.doi.org/10.1136/bmjgh-2019-001501 The Journal's website is at: https://gh.bmj.com/content/4/3/e001501.abstract |
| author2 |
Brac James P. Grant School of Public Health |
| author_facet |
Brac James P. Grant School of Public Health Elsey, Helen Agyepong, Irene Huque, Rumana Quayyem, Zahidul Baral, Sushil Ebenso, Bassey Kharel, Chandani Shawon, Riffat Ara Onwujekwe, Obinna Uzochukwu, Benjamin Nonvignon, Justice Aryeetey, Genevieve Cecilia Kane, Sumit Ensor, Tim Mirzoev, Tolib |
| format |
Journal Article |
| author |
Elsey, Helen Agyepong, Irene Huque, Rumana Quayyem, Zahidul Baral, Sushil Ebenso, Bassey Kharel, Chandani Shawon, Riffat Ara Onwujekwe, Obinna Uzochukwu, Benjamin Nonvignon, Justice Aryeetey, Genevieve Cecilia Kane, Sumit Ensor, Tim Mirzoev, Tolib |
| author_sort |
Elsey, Helen |
| title |
Rethinking health systems in the context of urbanisation: Challenges from four rapidly urbanising low-income and middle-income countries |
| title_short |
Rethinking health systems in the context of urbanisation: Challenges from four rapidly urbanising low-income and middle-income countries |
| title_full |
Rethinking health systems in the context of urbanisation: Challenges from four rapidly urbanising low-income and middle-income countries |
| title_fullStr |
Rethinking health systems in the context of urbanisation: Challenges from four rapidly urbanising low-income and middle-income countries |
| title_full_unstemmed |
Rethinking health systems in the context of urbanisation: Challenges from four rapidly urbanising low-income and middle-income countries |
| title_sort |
rethinking health systems in the context of urbanisation: challenges from four rapidly urbanising low-income and middle-income countries |
| publisher |
BMJ Journals |
| publishDate |
2022 |
| url |
http://hdl.handle.net/10361/16480 http://dx.doi.org/10.1136/bmjgh-2019-001501 |
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