Lecture 11: Health systems Flashcards
(47 cards)
Alma-Ata Declaration
emerged as a major milestone of the twentieth century in the field of public health, and it identified primary health care as they key to the attainment of the goal of health for all
Highlighted multiple stakeholders need to make a commitment in order to make this work
First international declaration underlining the importance of primary healthcare
International Conference of Primary Health Care
When it comes to primary health care they highlight that essential health care should be based on practical, scientifically sound and socially acceptable methods of care
Also highlight:
o Bring healthcare as close as possible to the people
o Governments have a primary responsibility for the health of their people
o People have both the right and duty to participate individually and collectively to participate in the planning and implementation of healthcare
Health for All
Strong relationship between health systems, health, wealth and social well being
o Healthy people are more likely to be employed, and less likely to take sick days, more likely to be more productive, and less likely to retire early
Generally speaking lower income countries will see great benefit from investing in very basic interventions, such as hygiene sanitation issues, immunization, bug nets
How we share advanced knowledge
How we share health information online
Primary care
Generally speaking, we are speaking about first contact care
Primary healthcare is the level of healthcare the provides entry into the health system for all other needs and problems that might arise
Primary healthcare: first contact care as well as health promotion and prevention seen in public health initiative
o More basic level of healthcare
o Deals with the majority of healthcare related issues
o If you don’t feel well do you have access to a doctor?
Strong primary healthcare includes
Diagnosis and treatment
Management of healthcare problems
Providing ongoing support
Includes things such as health prevention and promotion
Characteristics of Primary healthcare
Based on evidence based medicine
Are universally available
Should be affordable
Should address the actual needs of the community
Provide preventative care, curative care as well as retaliatory services
Should be linked to more advanced levels of healthcare through a referral system
Secondary care
Medical care provided by a specialised or facility upon referral by a primary care physician
Tertiary care
Specialized consultative care, usually on referral from primary or secondary medical care personnel, by specialists working in a center that has personnel and facilities for special investigation and treatment
o Example: cancer care centers
WHO 5 elements to provide primary care for all
Reducing exclusion and social disparities in health
Organizing health services around people’s needs and expectations
Integrating health into all sectors
Pursuing collaborative models of policy dialogue
Increasing stakeholder participation
Cuba’s life expectancy
79
Why is Cuba doing so well
They do make a lot of investments, its prioritized
Healthcare system is based on a term called Poly-clinics
o A place where a range of healthcare services are administered
o Diagnostic centers
o Family care
o Internal medicine
o Pediatrics
o Gynecology is apart of it
o X-rays and ultra sounds
o Emergency services
o Family planning
Health Systems
All activities whose primary purpose is to promote, restore or maintain health
Agencies that plan, fund and regulate health care
The money that finances healthcare
Those who provide preventative health services
Those who provide clinical services
Those who provide specialized inputs, such as the education of the healthcare professionals
Production of drugs and medical devices
Vertical Approach
Public health initiatives targeted at addressing a single disease/health condition at a time
Ultimate goal to eradicate or reduce the prevalence of the disease
Vertical approaches are not as beneficial as if a specific thing is included in a horizontal approach
When is vertical approach used
Vertical programs are necessary if primary health care is not sufficient and it’s a temporary solution
o If you want to address the needs a specific target group that is hard to reach
o If it needs to be a quick fix
o When you need very high skilled people to do a couple of things
Horizontal approach
Public health initiatives focused on integrated delivery of general health services and tackling overall health problems
Aim is to develop health networks that cater to people’s day-to-day health issues
Changing nature of healthcare globally
Development of pharmaceuticals
Technological advancements
Surgical advances
Treatment of non-communicable diseases
Global Health System
The group of actors whose primary intent is to improve health, along with the rules and norms governing their interactions
Organized social response to health conditions at the global level
WHO is the only real actor in global health systems, because of its universal memberships
Other global health system organizations
UNICEF
World bank
Global governance for health
The way in which the global health system is managed; no government at the global level
Example: formal decision-making processes of the UN; voluntary codes of conduct or organizations
Key stakeholders for global health
UN systems US is a key player in a lot of things National governments Philanthropic organizations Academic organizations
4 essential functions of the global health system
- Production of global public goods
o Referring a lot to knowledge related goods
o Any tools that your using to standardize the language when talking about health and disease (international classifications) - Management of externalities across countries
o Trying to prevent negative effects of ill health
o Surveillance systems to monitor progression of disease
o What response mechanisms are set in place
o Coordination mechanisms with other countries - Mobilization of global solidarity
o Mostly provided through the provision of aid
o Donor aid
o Technical cooperation and capacity is also involved here
o Humanitarian assistance during disasters - Stewardship
o Ontario ministry of health and long-term care: provide overall strategic direction
Importance of health systems
Improving the health status of individuals, families and communities
Defending the population against what threatens its health
Protecting people against the financial consequences of ill health
Providing equitable access to people-centred care
Making it possible for people to participate in decisions affecting their health and health system
3 measures of health system performance
attainment of good health
looking at both at how the health system can improve or protect peoples health
concerned with how long you could live in good health (disability and disease free)
Responsiveness to the expectations of the population
Referring to goals of the health system to reduce inequalities in a way that improves the situation for the people who are the worst off
Client oriented? Is it responsive to their expectations
Fairness of financing
Ways in which you pay for health care
Does the healthcare system do anything for reducing the burden of out of pocket expensive for health care
4 functions of health systems
Providing health services
Generating human/physical resources for service delivery
Raising/pooling resources to pay for health services
Stewardship (govern and regulate the health system)
