Access to healthcare

Question 1

Tanahashi framework

Answer 1

1. Availability
2. Accessibility
3. Acceptability
   - People WILLING to use the service
4. Contact coverage
   - Who actually use the service
5. Effectiveness
   - People who receive EFFECTIVE CARE (followed-up)

Question 2

Barriers at each stage of the Tanahashi framework

Answer 2

1. Availability
   - Absence of services
   - Inadequate infrastructure
   - Resources
2. Accessibility
   - Physical/geographical barriers
   - Administrative barriers
   - Financial cost (indirect too)
3. Acceptability
   - Structural discrimination due to sociocultural factors
   - Doctor bias
4. Contact coverage
5. Effectiveness
   - Lack of adherence
   - Non-effective interactions
   - Methods/demands of treatment
   - LACK OF FOLLOW-UP

Question 3

Conditions more common in rural areas

Answer 3

• Chronic diseases
• Head/neck/lip cancer
• Melanoma
• Mental health (10% more likely)
• Dental problems
• Obesity
• Substance abuse, e.g. smoking

Question 4

Civil & political rights

Answer 4

• Cost-free
• Immediately enforceable

Question 5

Economic, social and cultural rights

Answer 5

• Progressively realised
• Resource intensive

Question 6

Freedom

Answer 6

• Right to control one’s body and health (sexual and reproductive rights)
• Freedom from interference

Question 7

Entitlements

Answer 7

• Right to a health system that provides everyone an equal opportunity to experience the “highest attainable level of health”

Question 8

Human rights law

Answer 8

• Hard to enforce
• Lack of international consensus around rights and what constitutes their violation
• Absence of legislation and bodies at the state level

Question 9

Paris principles

Answer 9

• Early 1990s
• Criteria that National Human Rights Institutions must meet

Question 10

Fee-for-service

Answer 10

Greater freedom for patients