decisions in making health systems Flashcards
Cost effective analysis
cost is measured against the effectiveness of the different intervention
same outcome, diff interventions
limitation- it is difficult to compare interventions with different natural effects
cost of utility analysis
cost incurred is measured against the utility related to health- different health outcomes and interventions
measure quality adjusted life year- measure number of years gained and quality of life
cost benefit anlysis
cost of intervention compared to the all benefits
limitations of economic evaluations
Lack of routinely collected data in the health
system
• Results are often country-specific| context
• Based on assumptions around patient
pathways through care
• Methodological controversies surrounding
how to measure costs and outcomes.
• But overall useful in thinking about how to
spend scarce resources
UHC
ensures everyone acesses the health service they need, with good quality and doesn’t leave them in financial hardship
social determinants of health
health behavior
clinical care- acess to care and quality
physical environment- housing, transport, water quality, air quality
SES- education, occupation, community support and family
what makes an effective health system
deliver quality service good leadership good quality medicine and tech reliable info to base decisions for policies well trained and adequately paid staff robust financing system
health policy triangle
actors, content, context, process
process(health policy triangle)
agenda setting, policy formulation, policy implementation, policy evaluation
implementation(part of process)
Top down:
Policy decided at national level & translated into operating instructions for
use by lower level operatives
Implementation a technical process conducted by administrative
agencies (Command & Control leadership)
Bottom up:
Implementing actors have own power, & re-make policy
through practice;
They may undermine or enable achievement of central
actors’ goals, and they often generate unexpected
consequences
essential practices for leaders
Ethical Behaviour
Collective Sense making
Stakeholder analysis- agenda
celebrate small wins
types of stakeholders
key
primary
secondary
tertiary
advocacy tools
Informing/sensitizing Making presentation Lobbying Petitioning Negotiating (conflict resolution) Debating Pressuring
advocacy steps
identify action set goals and objectives info gathering determine targets messaging strategy plan of action
