Final Flashcards
Who definition of health systems
a. Sum of organizations, institutions, and resources whose primary purpose is to improve health
components of health systems
- Agencies that plan, fund and regulate health care
- The money that finances health care
- Those who provide preventive health services
- Those who provide clinical services
- Those who provide specialized inputs into health care,
such as the education of healthcare professionals and the
production of drugs and medical devices
goals of health systems
- Good health
- Responsive to society expectations
- Fairness of financial contribution
functions of health systems
- Provide health services
- Generate resources
- Financing = pay for health services
- Stewardship = govern and regulate health systems, partly government
US health system
all four, pluralistic
UK
beveridge model
germany
bismarck model, sickness found
canada
NHI model, partnership between government and private, like medicare
Out-of-pocket model
fee determined by market
levels of care
a. Primary
b. Secondary
c. Tertiary
primary health care
a. Essential and socially acceptable
b. Based on evidence and universally available
c. Addresses the needs of the community and is affordable
d. Provides preventive, promotive, curative, and rehabilitative services
e. Linked to health system through referral system
alma alta
- First articulated in Declaration of Alma-Ata
- Established health as a human right
- Primary health care is care that is essential and socially
- acceptable, based on evidence and made universally
available - Set the goal of “health for all” by 2000
- Important to identify as different than “primary care” –
meaning first level care
medicare
funded by SS tax, for 65+, insurance program
medicaid
assistance program, serves low-income people of every age
key health sector issues
a. Availability
1. Facilities, staff, supplies
b. Accessibility
2. Geographically and physically accessible
c. Affordability
1. Economically accessible
d. Acceptability
1. Respect for patient
e. Quality
1. Management, maintenance, skills
why is being born female more dangerous
a. Increased susceptibility to some infections
b. Cervicle, ovarian, breast
c. More susceptible to STI
why females are more physiologically susceptible to infections
a. Women have larger mucosal area more opened to the outside world
b. Men have larger amount of semen larger viral load
three delays
-delay in recognizing complications and seeking care
-delay in transport of mother to hospital
-delay in providing needed emergency obstetric care
physiological determinants of women’s health
- Increased susceptibility to some infections
- Cervicle, ovarian, breast
- More susceptible to STI
- Women have larger mucosal area more opened to the outside world
- Men have larger amount of semen larger viral load
social determinants of women’s health
- Gender norms and roles
- Female abortion or infanticide
- Fed less nutritious food
- Male dominance physical and sexual abuse
- Cooking with poor ventilation responsible for disease
- Low social status limits access to health care
sex-selective abortion
a. In a natural setting, there are more females born 100:105
b. Skewed ratio of male to female with sex-selective abortion
1. Chindi
2. India
3. Taiwan
4. Singapore
5. South korea
c. Education and income role
1. Can tell gender earlier more abortion
2. Doesn’t change attitude, still want son and only 2 kids
3. Wrong incentive
complications of unsafe abortion
a. Highest in middle Africa
b. Leading and preventable cause of maternal deaths and morbidities
c. Lack of access to safe, timely, affordable and respectful abortion care
which region has the highest rate of unsafe abortion
a. South africa
b. The US is high and not going down
c. Lowest = the netherlands
leading causes of maternal death globally
a. Indirect causes
b. Hemorrhage
c. Hypertensive disorders
obstetric fistula
- result of prolonged labor
a. a hole in the birth canal caused by obstructed labour
b. social isolation
FGM/C
a. piercing, cutting, removing, or sewing closed all or part of a girl’s or woman’s external genitals
solutions FGM
- awareness
- signs and symptoms
- education
- involve men in the convo
- funding
Mexico city policy
a. Requires NGOs (foreign) to certify that they will not perform or actively promote abortion as a method of family policy or they will not receive US funding
b. 1980
c. Based on party in office, not research
d. In Jan 2017, Trump wanted all US funding cut for almost all global health program areas
TB
a. Caused by bacteria
b. 1/3 have TB, a lot are inactive
d. It will only get more expensive; it is cheaper to contain it where it is
types of resistance of TB
- 2 or 3 = multidrug resistant, mdr
- Xdrt = resistant to everything we have right now, extended drug resistant TB
risk factors of TB
- Malnutrition
- HIV
- Damp
DOTS for TB
- Early detection of TB patients via smear microscopy followed by directly observed 6-month treatment
China DOTS
- improved DOT (starting in 1994)
- Adequate funding, leadership, a sound technical approach
- Local TB clinics, and free diagnosis
- From 1991 to 2000, 8 million were evaluated
- 3.53 million had smear positive results
- Treatment was free
HIV/AIDS
a. Higher risk with anal
b. Retro-virus
c. Treatment is part of prevention to decrease viral load
d. Circumcision can decrease viral load (Langer Haan cells in mucous area, right were HIV thrives)
e. AIDS = active stage of HIV
f. Colonialism brought about stigma
life cycle
women are at higher risk of HIV because
lower SES and cultural status , large mucosal area in vagina, exposed to large viral load in male semen
concentrated epidemic
when 1 percent or less of population of adults are infected
1. Most at risk population (MARP): sex workers, MSM, injecting drug users, Cambodia
generalized epidemic
more than 5 percent the adult population is infected.
1. South Africa, Zimbabwe, Botswana, etc
regional variation of main routs of transmission of HIV/AIDS
East Europe and Central Asia
injecting drug users
- all others
- sex worker clients
- sex workers
- men who have sex with men
Latin America
- all others
- men who have sex with men
- injecting drug users
- sex worker clients
- sex workers
South and southeast asia
- sex worker clients
- all others
- injecting drug users
- sex workers
- men who have sex with men
Malaria
a. “bad air”
b. Parasite
c. 2 hosts
d. Vector-born disease
e. ½ world population at risk
f. Parasite population increased because agricultural revolution, trading and new permanent settlers
g. Eliminated in the US, all cases are related to travel
h. Originally used DDT
plasomodium falciparum
severe, can lead to coma, most common, sub Sahara and Mediterranean
plasmodium vivax
asia
2 hosts of malaria
more complex to battle, break one leg, get rid of transition and disease
- mosquito
- human
treatment of malaria
chloroquine
air conditioning
close doors and windows, not sleeping outside anymore
pregnant women and malaria
have to pee more, have to go outside to use the bathroom more
most at risk for malaria
- Kids
- Tropical and subtropical regions
- Rural areas
transmission of malaria
- 1 type of mosquito
- Vector = female anopheles mosquito
- Host = human
- Only preg female mosquito
- Not male
prevention of malaria
- Medications
- Mosquito elimination
- Prevention of bites
treatment of uncomplicated malaria
chloroquine
treatment of complicated malaria
artesunate
re-occurrence
disease not totally cleared before it comes back
relapse
re-emergence of blood-stage disease from latent disease
re-infection
you had the disease, were cleared of it, and now you have it again
PEPFAR
- US President’s emergency plan for aids relief
- initiated by W. Bush
Non-communicable diseases
cannot be spread by an infectious agent, they
last a long time, and they are often
disabling and lead to death if not
treated appropriately
e. Also referred to as chronic diseases
and degenerative diseases
NCDs
- burden is greater than burden of communicable diseases in low, middle, and high-income countries (excluding SSA)
- burden will continue as countries develop
- risk factors related to lifestyle
CVD
disease of the heart or blood vessels. This term encompasses both ischemic heart disease and stroke
Cholesterol
a fatlike substance that is made by the body and is found naturally in animal-based foods such as meat, fish, poultry, and eggs
diabetes
an illness caused by poor control by the body of blood sugar
hypertension
high blood pressure, with a
reading of 140/90 or greater
ischemic heart disease
a disturbance of
the heart function due to inadequate supply
of oxygen to the heart muscle
stroke
sudden loss of function of the brain
due to clotting or hemorrhaging
cancer
a. Unique challenge because there are many
forms and each may have different
characteristics
b. All forms of cancer made up about 16% of all
deaths and 9.2% of DALYs and for all age
groups and both sexes in 2016
c. Breast cancer is the leading cause of cancer
death in low- and middle-income countries
and for women globally
most important risk factor for type 2 diabetes
obesity
