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Nottingham Trent University (2020)

Developing governance to foster healthcare quality in Kurdistan semi-autonomous region of North-Iraq

OMER, A.

Titre : Developing governance to foster healthcare quality in Kurdistan semi-autonomous region of North-Iraq

Auteur : OMER, A.

Université de soutenance : Nottingham Trent University.

Grade : Doctor of Philosophy (PhD) 2020

Résumé
The governance of healthcare quality is a global priority In many countries and regions, including the Kurdistan Region of Iraq (KRI), it is also a vital development issue. Given the decreasing threat of ISIS in the region, it is opportune to consider how the nettle of its improvement might now be seriously grasped.

In this thesis, I aim to develop of system of benchmarks for the governance of healthcare quality and measure the KRI system of governance in theory and practice in their light thesis. In order to understand the actuality of the KRI system for this end, I have both drawn systematically on the existing literature and conducted a significant programme of empirical research, which consists of 32 semi structured interviews conducted with KRI health policy makers, hospital directors, and healthcare practitioners. Whilst the benchmarks have been a critical lens through which to examine the actuality of the KRI system it is also true that, to some extent, they have been refined by the examination of the actuality of the KRI system. A good example is how the empirical evidence of significant clientelism that I found in the KRI system influenced me to emphasise clientelism amelioration measures significantly in my system of benchmarks. This has meant that to some extent the benchmarks are specifically tailored to the KRI situation, though I am confident that most or all of them would at least be largely pertinent as tools for the critical examination of the governance of healthcare quality in other jurisdictions.

Whilst there is growing evidence of healthcare quality issues in the KRI primary care, this thesis adds very significantly to the existing knowledge and shines a particular light on the role of governing authorities in supporting healthcare quality and ultimately also of the role of law under the KRI healthcare system. The key finding is that the KRI system of health governance falls significantly below the benchmarks of best practice. More specifically, in law and governance have not been properly effective in combating clientelism and its consequences and serious problems exist with risk management the provision of sufficient resource and the provision of patient-centred care. In this light, at the end of the thesis, I thesis make a range of recommendations for reform and put forward an action plan founded partly on the development of a Professional Medical Regulatory Authority (PMRA). To foster the use value of the thesis I will be communicating this plan to KRI health policy makers.

Présentation

Page publiée le 25 janvier 2023