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1
Q

Who definition of health systems

A

a. Sum of organizations, institutions, and resources whose primary purpose is to improve health

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2
Q

components of health systems

A
  1. Agencies that plan, fund and regulate health care
  2. The money that finances health care
  3. Those who provide preventive health services
  4. Those who provide clinical services
  5. Those who provide specialized inputs into health care,
    such as the education of healthcare professionals and the
    production of drugs and medical devices
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3
Q

goals of health systems

A
  1. Good health
  2. Responsive to society expectations
  3. Fairness of financial contribution
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4
Q

functions of health systems

A
  1. Provide health services
  2. Generate resources
  3. Financing = pay for health services
  4. Stewardship = govern and regulate health systems, partly government
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5
Q

US health system

A

all four, pluralistic

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6
Q

UK

A

beveridge model

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7
Q

germany

A

bismarck model, sickness found

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8
Q

canada

A

NHI model, partnership between government and private, like medicare

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9
Q

Out-of-pocket model

A

fee determined by market

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10
Q

levels of care

A

a. Primary
b. Secondary
c. Tertiary

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11
Q

primary health care

A

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

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12
Q

alma alta

A
  1. First articulated in Declaration of Alma-Ata
  2. Established health as a human right
  3. Primary health care is care that is essential and socially
  4. acceptable, based on evidence and made universally
    available
  5. Set the goal of “health for all” by 2000
  6. Important to identify as different than “primary care” –
    meaning first level care
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13
Q

medicare

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funded by SS tax, for 65+, insurance program

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14
Q

medicaid

A

assistance program, serves low-income people of every age

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15
Q

key health sector issues

A

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

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16
Q

why is being born female more dangerous

A

a. Increased susceptibility to some infections
b. Cervicle, ovarian, breast
c. More susceptible to STI

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17
Q

why females are more physiologically susceptible to infections

A

a. Women have larger mucosal area  more opened to the outside world
b. Men have larger amount of semen  larger viral load

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18
Q

three delays

A

-delay in recognizing complications and seeking care
-delay in transport of mother to hospital
-delay in providing needed emergency obstetric care

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19
Q

physiological determinants of women’s health

A
  1. Increased susceptibility to some infections
  2. Cervicle, ovarian, breast
  3. More susceptible to STI
  4. Women have larger mucosal area  more opened to the outside world
  5. Men have larger amount of semen  larger viral load
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20
Q

social determinants of women’s health

A
  1. Gender norms and roles
  2. Female abortion or infanticide
  3. Fed less nutritious food
  4. Male dominance  physical and sexual abuse
  5. Cooking with poor ventilation  responsible for disease
  6. Low social status limits access to health care
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21
Q

sex-selective abortion

A

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

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22
Q

complications of unsafe abortion

A

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

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23
Q

which region has the highest rate of unsafe abortion

A

a. South africa
b. The US is high and not going down
c. Lowest = the netherlands

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24
Q

leading causes of maternal death globally

A

a. Indirect causes
b. Hemorrhage
c. Hypertensive disorders

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25
obstetric fistula
- result of prolonged labor a. a hole in the birth canal caused by obstructed labour b. social isolation
26
FGM/C
a. piercing, cutting, removing, or sewing closed all or part of a girl’s or woman’s external genitals
27
solutions FGM
1. awareness 2. signs and symptoms 3. education 4. involve men in the convo 5. funding
28
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
29
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
30
types of resistance of TB
1. 2 or 3 = multidrug resistant, mdr 2. Xdrt = resistant to everything we have right now, extended drug resistant TB
31
risk factors of TB
1. Malnutrition 2. HIV 3. Damp
32
DOTS for TB
1. Early detection of TB patients via smear microscopy followed by directly observed 6-month treatment
33
China DOTS
1. improved DOT (starting in 1994) 2. Adequate funding, leadership, a sound technical approach 3. Local TB clinics, and free diagnosis 4. From 1991 to 2000, 8 million were evaluated 5. 3.53 million had smear positive results 6. Treatment was free
34
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
35
life cycle
36
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
37
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
38
generalized epidemic
more than 5 percent the adult population is infected. 1. South Africa, Zimbabwe, Botswana, etc
39
regional variation of main routs of transmission of HIV/AIDS
40
East Europe and Central Asia
injecting drug users - all others - sex worker clients - sex workers - men who have sex with men
41
Latin America
- all others - men who have sex with men - injecting drug users - sex worker clients - sex workers
42
South and southeast asia
- sex worker clients - all others - injecting drug users - sex workers - men who have sex with men
43
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
44
plasomodium falciparum
severe, can lead to coma, most common, sub Sahara and Mediterranean
45
plasmodium vivax
asia
46
2 hosts of malaria
more complex to battle, break one leg, get rid of transition and disease - mosquito - human
47
treatment of malaria
chloroquine
48
air conditioning
close doors and windows, not sleeping outside anymore
49
pregnant women and malaria
have to pee more, have to go outside to use the bathroom more
50
most at risk for malaria
1. Kids 2. Tropical and subtropical regions 3. Rural areas
51
transmission of malaria
1. 1 type of mosquito 2. Vector = female anopheles mosquito 3. Host = human 4. Only preg female mosquito 5. Not male
52
prevention of malaria
1. Medications 2. Mosquito elimination 3. Prevention of bites
53
treatment of uncomplicated malaria
chloroquine
54
treatment of complicated malaria
artesunate
55
re-occurrence
disease not totally cleared before it comes back
56
relapse
re-emergence of blood-stage disease from latent disease
57
re-infection
you had the disease, were cleared of it, and now you have it again
58
PEPFAR
- US President’s emergency plan for aids relief - initiated by W. Bush
59
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
60
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
61
CVD
disease of the heart or blood vessels. This term encompasses both ischemic heart disease and stroke
62
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
63
diabetes
an illness caused by poor control by the body of blood sugar
64
hypertension
high blood pressure, with a reading of 140/90 or greater
65
ischemic heart disease
a disturbance of the heart function due to inadequate supply of oxygen to the heart muscle
66
stroke
sudden loss of function of the brain due to clotting or hemorrhaging
67
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
68
most important risk factor for type 2 diabetes
obesity

Global Health (2 decks)

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