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International Journal of Epidemiology 2001;30:717-719
© International Epidemiological Association 2001

Forum

Economic and health care restructuring— the need for better governance

Chitr Sitthi-amorn, Ratana Somrongthong and Wattana S Janjaroen

Chulalongkorn University, College of Public Health, 10th Floor, Institute Building 3, Soi Chula 62, Phyathai Road, Bangkok 10330, Thailand. E-mail: chitr@md2.md.chula.ac.th

The first 150 words of the full text of this article appear below.

In recent years, public health in developing countries has been affected by the restructuring in both the health and non-health sectors (e.g. education, employment, transport), and international politics. Economic and health care restructuring have had an impact on health. We aim to highlight some key events in South-East Asia and their effect on public health during the past 15 years and to propose measures to deal with the phenomena.

Health impact of restructuring in the non-health sector

Globalization has brought about restructuring that impacts on health and health care. The economic boom in most developing countries has seen a restructuring around cheap labour, foreign investment and oil discovery.1 Unfortunately, restructuring has not put in place adequate governance—the systems of management, monitoring and evaluation—to ensure transparency and accountability.2 Thus, in South-East Asia, the boom was followed, in 1997, by a crisis sparked by the devaluation of the Thai and Malaysian currencies. The crisis threatened to become a global economic . . . [Full Text of this Article]

Health effects of globalization in the health sector

Health effect of international politics

What needs to be done?

Strategies at the national level
Uphold values of public health
Appropriate restructuring involving public health values and new players
Focus on evidence-based decisions
Participation of intended beneficiaries in evidence-based policy decisions
Strategy of the international community

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