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Quiz 2 Flashcards

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1
Q

What is the goal of health systems around the world

A

Achieve the best possible outcomes at the lowest price in the fairest way

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2
Q

T or f countries with more health services tend to have higher life expectancies

A

True

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3
Q

What is a health system

A

The sum of organizations, institutions, and resources whose primary purpose is to improve health.

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4
Q

What is a health system composed of? (6)

A

Agencies that plan, fund, and regulate healthcare
The money that finances healthcare
Preventative service providers
Clinical service providers
Rehab service providers
Specialized input providers such as education of hc profession

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5
Q

In the world health report, what were the goals of the system

A

Good health, fair financing, respond to the expectations of the population

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6
Q

In the world health report, what were the functions of the system

A

Provide health services
Resource generation
Financing
Stewardship

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7
Q

According to the world health report, what should the system do?

A

Provide access to comprehensive services
Protect their sick and families against financial costs
Improve population health through effective governance

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8
Q

What are the health system building blocks in the WHO health system framework?

A

Service delivery
Health workforce
Information
Medical products, vaccines, and technologies
Financing
Leadership / governance

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9
Q

What are the overall goals/outcomes of the whole health system framework?

A

Improved health level and equity
Responsiveness
Social and financial risk protection
Improved efficiency

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10
Q

Generally, as country income increases, how are are health systems organized?

A

Spend more money on health
Focus on universal health coverage
Attend to efficiency, effectiveness, quality, and fairness of hcs

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11
Q

What are the key points of national health service

A

Universal coverage with a single payer system
Some private
Mostly owned by the gov
Health as a human right
Public ownership of facilities
Private and government employment of providers
Public insurance

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12
Q

What countries have national health services

A

UK, Cuba ( no privatization at all)

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13
Q

What is national health insurance

A

Everyone is covered, private options, insurance for agreed upon service surrounded
Health is a right
Public and private ownership of facilities
Private employment of providers
Insurance from gov, single payers, and taxes
Financing of insurance from Indv deductions and employer deductions

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14
Q

What countries have universal health insurance

A

Canada, France, and germany

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15
Q

What is pluralistic healthcare

A

Large private role
Health isn’t a right
Public, private, and not for profit ownership of facilities
Mainly private employment of providers
Insurance is fragmented (some or none)
Some tax based, some employer/employee, some indv purchase of insurance

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16
Q

What countries have pluralistic healthcare

A

USA, Cambodia, Nigeria

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17
Q

According to the video, who has the best healthcare system

A

Rankings: France
values based
No clear winner
What works in one place won’t work in another

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18
Q

What type of insurance do most low income countries have

A

Fragmented

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19
Q

What insurance system do most high income countries have

A

Universal healthcare based on social insurance

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20
Q

What was the declaration of Alma ata

A

Health became a human right
People had the right to plan and play a role in healthcare

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21
Q

What is primary health care

A

Essential and socially acceptable
Based on evidence
Universally available
Provides variety of services
Referral system

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22
Q

What is the public sector responsible for

A

Stewardship
Raising funds
Making key decisions
Establish approaches to health insurance

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23
Q

What is the private, for profit sector for

A

Provision of services and operations
May partner with public sector

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24
Q

What is the ngo, private, not for profit sector for

A

Community based efforts
Health services
May partner with public sector

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25
What are the 3 fundamental concerns uhc reflects
Access, quality, protection
26
What is the sustainable development report
Global assessment of countries progress towards achieving sustainable development goals
27
What are some key health sector issues
Demographic and epidemiological change Stewardship Human resource issues Quality of care Financing health systems Financial protection and provision of universal coverage Access and equity
28
T or f: it is important to keep financing and provision separate
True
29
Health inequity
Differences in health that are not only unnecessary and unavoidable, but also unfair and unjust
30
Health inequality
Differences in health status or in the distribution of health determinants between different population
31
Health disparities
A difference in health that is closely linked with social or economic disadvantage
32
What are the links between health and education
Intergenerational links (parent health and education affects kids) Malnutrition and disease affects children’s cognitive development and school performance Education enables better disease prevention and management
33
How does decreased social and political power affect health
Decreases health, services, and financial protection. Also leads to inequities, inequality, and disparities
34
How does increased parental education impact children’s health
Increases parent health and therefore increases child’s health
35
How does maternal education impact mortality rate in children under 5
Each year of maternal education decreases mortality rate by 7-9%
36
How does health impact productivity and earnings?
Increases longevity and lifetime earnings (long life=more time to work) Healthy workers are more productive Ill people can’t work and can’t make money
37
How does health go along with the costs of illness and poverty
Illness is expensive and can cause families to go into poverty Illness=less earnings Long lasting disability is expensive: measles or meningitis causes brain damage which is expensive
38
Where can health disparities occur
Across countries Within a country Based on a location Income Gender Ethnicity Marginalization
39
How can health disparities occur across countries
Differences in indicators Status of economic development Inequitable relationships between countries Political choices Ex maternal mortality in sierra lione=450x higher than Greece, Iceland, and poland
40
How can health disparities occur within countries
Variation in indicators across population groups Countries with significant ethnic minorities Status of economic development across the world Ex. Poor infant mortality rates in Nunavut in compared to the more urban provinces
41
How can health disparities occur in different locations
Urban dwellers have better access to services and coverage and therefore better health Rural dwellers have lower income, less education, less access and a weaker political voice
42
How do health disparities occur based on income?
Gap in access, coverage, fairness, and benefits Higher income= better education, housing, health services, work environments
43
How do health disparities occur based on gender
Being born female is dangerous for your health Worse in lower income countries Women face health concerns based on their diminished place in society Aren’t believed, under researched, blame a lot of problems on being a woman
44
How do health disparities occur based on ethnicity
Strong association between ethnicity and health status, access, and coverage Linked to strong association between ethnicity and power, education, and income
45
How do health disparities occur based on marginalization
People in stigmatized occupations, with physical disabilities, prisoners, and LGBTQ2S+ suffer inequality
46
What is the cost-effectiveness analysis tool
Comparing the cost of investment with the amount of health that can be purchased Or Comparing the costs and the gains of different health interventions Ex. DALYs averted
47
What are some considerations for the cost-effectiveness analysis
Equity Burden of disease Serves the whole society Impact on the provision of insurance Capacity to deliver the service (diversity) Links between the service and other services Ability to change budget for the proposal Transitional costs with the proposal
48
What do we know about disasters
Primary cause of morbidity and mortality Increasing in frequency Nurses can play an important role but receive little training
49
Most high income countries spend how much of their GDP on health
9-12%
50
Most low income countries spend how much of their GDP on health
3-6%
51
What is nurses role in disasters
Risk assessment Multidisciplinary management Addressing tough questions such as where the bodies of the dead stored and how
52
What is a disaster
Result of an ecological breakdown in relation between humans and their environment Sudden event on such a scale that community needs extraordinary efforts to cope May require outside help
53
Who are some of the players in disasters
Police, Fire, EMS, Hospitals, Volunteers, public health, elected officials, civil servants, utilities, transit, provincial/federal agencies, media
54
What is incident command/management system
Way to organize command in a disaster in order for things to run smoothly Many people involved, but one person must be in command Command and control Standard components Standard sequence of events
55
What are the 3 types of disasters
Natural (hurricane, tornado, blizzard, earthquake, extreme temps etc.) Human made (terrorism, mass casualty, abduction, hostages, bomb threat) Technological (electrical failure, transport failure, communication failure)
56
What are the main hazards with hurricanes/tornadoes
Drowning and injuries
57
What are the main hazards with tornadoes
Injuries from debris, head and chest trauma
58
What are the main hazards with floods
Drowning and disease from contaminated water
59
What are the main hazards from earthquakes
Injuries from trapping and crushing
60
What are the main hazards from volcanoes
Respiratory injury from ashes Injury from lava or mud flows
61
Why is it important to know the mechanism of injury for each event?
To be able to plan accordingly with supplies and resources and approaches to care
62
What are the patterns of mortality and injury from disaster
Water=more death Floods, storm surges, and tsunamis have more deaths than injuries Earthquakes and wind events have more injuries than deaths Higher risk of injury and death in developing countries (at least 10x)
63
T or F, any assistance is good in a disaster
Wrong, need an organized response or else there is chaos
64
T or F epidemics are inevitable after disasters
Wrong, rare, dead bodies don’t = outbreaks, good public health ensures safety
65
T or F disasters bring out the worst in people
False, majority of responses are generous and spontaneous
66
What is the immediate response in disasters (what needs must be met right away)
Injuries, exposure, malnutrition, sanitation, mortality, mental health, vulnerable populations
67
What are some considerations for children in disasters
Need to listen to them Give easy to understand answers Make a safe space for them (play area) Need to keep families together School can be good to create a sense of normalcy after a disaster
68
What are some considerations for mental health in disasters
Help find peoples loved ones People need to have space to mourn and support Most people are back to normal within 2 weeks, but 1-3% will need additional support Beware of culture and know that support looks different for everyone (some cultures don’t acknowledge mental health)
69
What are some causes of communicable diseases in disasters
Increased vectors, flooded sewer systems, destruction of healthcare infrastructure, interruption of normal healthcare systems that prevent communicable diseases
70
What are the 4 phases of disaster response
Preparation (plan, train, educate) Response ( decrease morbidity and mortality, and property damage) Recovery (actions to return to normal) Mitigation/prevention (reduce consequences, decrease probability of it happening again)
71
What are some of the phases of a disaster
Pre disaster Impact Heroic phase Honeymoon phase Disillusionment phase Reconstruction phase
72
What are the components of the START triage method
Ambulatory Resp rate over 30 or none Perfusion (cap refill >2)) Mental status
73
How did health care workers help the premature babies in Rawanda
Volunteered to teach the local staff how to take care of babies, how to operate equipment and infection control strategies
74
Why did the pandemic cause a higher number of children’s deaths particularly in lower income countries
Couldn’t get timely treatment Lack of personnel Babies born to sick moms=sick babies Household income loss Disruption of care seeking Stalling or decline of preventative measures
75
What is the main neonatal mortality trend
The lower income, the higher mortality rate
76
In low income countries how much more likely are children under 5 to die than in North America/HI countries
12x
77
What is the main trend by REGION in the top 3 causes of under 5 deaths?
Preterm birth complications, congenital defects, LRTI
78
What are the main trends by country income group of leading causes of deaths under 5
LI: more communicable diseases, HI: more non-communicable diseases Congenital defects go from #10 in LI to #1 in HI Malaria is the top reason in LI
79
What are some considerations for pneumonia in children in LI countries
Only about 1/3 of kids receive antibiotics Many are immunocompromised from fighting multiple infections Environmental factors
80
What methods of prevention/treatment are the most effective for diarrheal disease
Oral rehydration therapy, zinc supplements, rota vaccine, breastfeeding, WASH
81
What is the difference between wasting and stunted
Wasting: height and weight drops 2 standard deviations from curve Stunted: height or weight drops 2 standard deviations from the curve
82
Malaria considerations for low income country children
Causes majority of young deaths in sub-Saharan Africa Can be contracted during pregnancy Treated with ACT (growing drug resistance) Prevention: bug nets, bug spray, chemo prevention, vaccination)
83
What are some challenges to the prevention of measles
Need to have 95% heard immunity Need to have 2 full doses to be immune Covid impacted the rate of vaccination
84
What are some considerations for soil transmitted helminths (parasites)
Worms Risk from walking bare foot or contaminated food/water Feed on blood from intestines Can lead to memory problems, intestinal problems Treatment: deworming
85
What are the trends for adolescent deaths
Road injuries infections in early adolescence to injuries in YA males Infection in early adolescence to maternal disorders in women
86
What unique challenges do adolescents face in LI countries that HI countries don’t
Chores Married young Family barriers to education (women)
87
T or F Sub Saharan Africa is 6x higher than Europe/Central Asia in older adolescent fertility rates
T
88
What are some considerations for adolescent pregnancy in LI countries
High fertility rates=risk of dying due to low resources and lack of education More at risk for complications Unsafe abortions are common
89
How did Cambodian researcher address anemia
Iron fish in soup
90
What biological differences and gender norms contribute to female adolesents increased risk of contracting HIV
Lack of control over choices during intercourse Pressure to participate in prostitution Age differences Not fully developed Vagina is more vascular than the penis
91
What are the principles of human rights
Universal Inalienable Indivisible and interdependent Includes the right to life
92
What is article 25 from the universal declaration of human rights
Everyone has the right to standard of living adequate for their health and wellbeing of himself and family Motherhood and childhood are in titles to special care and assistance regardless of wedlock
93
What is the challenge of the UDHR
Has force, but not the force of the law
94
What obligations do the governments have to the UDHR
Respect protect and fulfill the rights stated in the document Refrain from violating peoples rights Prevent others from violating peoples rights Actively promote the realization of rights
95
Health and the declaration of human rights
Strong link between human rights and health but there is no mechanism for holding countries accountable for honouring the right to health
96
T or F only Half the countries have health as a human right
T
97
What is the rights based approach
Assess policies, programs, and practices in terms of human rights Analyze and address the health impacts resulting from violations of human rights when considering ways to improve pop health Prioritize the fulfillment of human rights
98
What are the limits to human rights
Circumstances in which someone’s rights may be suspended (an outbreak, evacuation, mental health act) Suspension should be: As narrow as possible Carried out with due process and monitored during the suspension period and all efforts should be made to reinstate
99
Where should we focus on protecting the rights of people who are HIV positive
Employment Schooling Participation in social activities
100
What is the numberg code
First document to specify ethical principles in human research Voluntary consent is essential Human subjects should only be involved if it is necessary for societal good Limits and safeguards on risks
101
What is the declaration of Helsinki
Ethical principles to guide physicians on biomedical research on humans Most influential research guidelines
102
What is the Belmont report
Basic ethical principles and their application Developed research guidelines for human subject use
103
What 6 conditions must be met for human research
Value Validity Selection Risk/benefit ratio Consent Respect

Global Health (2 decks)

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