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The development of the discipline of public health in countries in economic transition: India, Brazil, China 

The development of the discipline of public health in countries in economic transition: India, Brazil, China
Chapter:
The development of the discipline of public health in countries in economic transition: India, Brazil, China
Author(s):

Puja Thakker

and K. Srinath Reddy

DOI:
10.1093/med/9780199218707.003.0004
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date: 06 December 2019

The three low- and middle-income countries (LMICs) profiled in this chapter are countries which together constitute nearly 45 per cent of the global population. These countries represent societies wherein the economies are on the upswing and are accompanied by demographic and epidemiological transitions profoundly influencing the agenda of public health as well as the level of resources available to address it. The dominant ideologies of both the state and society of the time, as can be seen in the social, political, and economic histories of these countries, have significantly influenced the development of public health.

As these countries focus on establishing strong systems for the delivery of health care, the role of the state has undergone substantial changes over time. The increasing dominance of market economics even in the health-care sector has substantially shaped the role of the private sector, and thus, the health-seeking behaviour of the population. Although a progressing economy has significantly increased national income per capita, the transition has varying impacts on the health system, especially raising concern over the quality of care delivered and the widening inequities in access to care.

Public health in LMICs has not succeeded in drawing upon interdisciplinary research and multisectoral action to the extent needed. Presently, the capacity for developing and implementing intersectoral policies is missing, and the active engagement of public health academia and health workers with the health system and policymakers is suboptimal. Although promising signs of a change are visible in some of these countries, the extent to which the discipline will advance further over the next two decades will be a critical determinant of health and development in the high-velocity transitional period that lies ahead.

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