Journal of Health Systems 2019-09-13T09:39:21-07:00 Dr. Muhammed Shaffi Open Journal Systems <p>Health Systems approach calls for a multi-dimensional analysis of health improvement in societies and is holistic unlike a segmented approach which discretely examines factors in isolation. Such a multi-dimensional analysis is a challenging task and requires an interdisciplinary competence. The Journal of Health Systems will strive to develop and facilitate such a competence and will promote critical scholarship in this area.</p> Is Cutting Edge Technology Cutting Cancer Treatment Cost? 2019-09-09T08:49:54-07:00 Raghuram K Nair <p>Cancer is the second most common disease responsible for mortality in India. Annually, 1.16 million persons are diagnosed with cancer and about 780,000 patients succumb to the disease. Every fifth individual in the 36-45 year age bracket is affected, resulting in huge personal expenditures and healthcare costs.1 Technological advancements in the last three decades have revolutionized the field of medical science. This development is more obvious in the field of oncology than any other discipline. But it is accompanied by rising healthcare costs. The heavy burden of cancer in our population and its rising costs warrants a close look at the cost-efficiency of our preventive, diagnostic and treatment interventions.</p> 2018-12-03T00:00:00-08:00 ##submission.copyrightStatement## Dengue in India: Recent Advances, Prognostic Concerns and Future Considerations - A Review 2019-09-13T09:39:21-07:00 Veena Iyer Kankshi Bhavsar Susanna Abraham Cottagiri Ayushi Sharma Vijay Kohli Vidhwan Singh Dhruvey Bhavin Solanki <p>The last semi centennial has witnessed Dengue’s expansion and escalation into all WHO regions, through the progressive build-up of hyperendemicity, to become the most important mosquito-borne disease in the world. India reports the fourth highest incidence of Dengue in the world, 14 cases per 100,000 population, after Brazil, Malaysia and Mexico. However, in 2014, a complexly designed study showed that India’s Dengue case rate is severely under-reported and estimated it to be probably higher than Brazil’s 291/100,000. India will, in all probability, experience many more outbreaks of Dengue as hyperendemicity gets established in our 4000-odd smaller cities and towns in the years to come. <br>We have characterized the available weapons against Dengue as 3Is – Insecticides, Immunologicals and Innovations. We have reviewed India’s budgetary allocations for Dengue control and surveillance in the past five years. We compare this with expenditures in other Asian countries. While India’s central allocation on all vector-borne diseases as part of 12th five-year plan was 0.36 USD per capita, Mexico, Malaysia , Brazil and Singapore spent 0.76, 3, 5 and 10 USDs per capita for Dengue surveillance and vector control in the same period. Even if we double this estimate of India’s central allocation on all vector-borne diseases (0.72 USD per capita), accounting for an equal contribution from states, it is lower than the total cost of illness per capita for Dengue in the country (0.88 USDs per capita). <br>Eradication of Dengue virus is theoretically possible before it establishes itself completely in the mosquito-vector and human populations. We have argued for improved surveillance as a necessary backdrop for dengue control strategies. With good infrastructure and manpower, these strategies could be up scaled in the future for eradication of the Dengue virus. We conclude with recommendations for a future systemic strategy that synthesizes surveillance and control measures to achieve zero-infestation of humans and mosquitoes by the Dengue virus.,</p> 2018-12-15T00:00:00-08:00 ##submission.copyrightStatement## Challenges to the Iraqi Health System Call for Reform 2019-09-09T09:10:20-07:00 Dilshad Jaff Katherine Tumlinson Ashraf Al-Hamadani <p>The Iraqi public health system has faced major challenges over the last four decades. Recurrent armed conflicts and political instabilities have resulted in service delivery that is of poor quality. This essay identifies the main challenges facing the Iraqi public health system and proposes a plan to initiate the process of addressing these challenges. Calls to action mandate a realistic assessment of the challenges posed by the current situation. Building on an understanding of these challenges and creating an environment to support evidence-based health system reform holds promise for creating a healthy future.</p> 2018-12-03T00:00:00-08:00 ##submission.copyrightStatement##