Final Flashcards
What is poverty relief?
Addresses the poors survival needs and immediate problems
Short term relief and goals
What is poverty reduction?
Process by which the causes of deprivation and inequity, and root causes of poverty are addressed
Takes into account multiple stake holders
Help develop potential, increase productive capacity, reduce barriers in terms of participating in society
Give some examples of poverty reduction
Technical and financial aid for development
Food security initiatives
Social welfare programs
Strengthening educational and occupational opportunities
Access to vaccination and medication
Strengthening health systems
Supporting local businesses
What are some strategies for poverty reduction?
Collaboration between rich and poor countries
Identify poor nations priorities for research/development
Learn what the country needs in foreign assistance
Education as a driver for economic growth
Realistic portrait of what poor countries can pay for
Poor countries should adopts a poverty reduction strategy
Describe collaboration between rich and poor countries
Well governed, politically organized developing countries get far too little help/donor aid
Describe the identification of poor nations priorities for research/development
Translating ideas and policies into practice
Focusing on projects at the national vs symbolic level
Describe the process of learning what a country needs in foreign assistance
Promoting bottom up approach (find out what they need first then give money)
Clear identification of goals and targets to be achieved
Describe a realistic portrait of what countries can pay for
Dropping user fees for essential health/educational services
Facilitating social policies and governance
Pro-poor spending
What are some things required for long term sustainable change?
Large-scale, long term donor financing for recipient countries to finance their investment plan
Harmonization of aid across various aid agencies
Decentralization of investments
Consider both infrastructure and operational costs
Capacity building of the public and private sectors
Improving info tech and transmission
Enable poor countries to respond to climate change
Reduce barriers to global trade
Strategies to monitor and evaluate aid flow/use
What are the core five principles underlying the PRSP approach of poverty reduction?
- Country-driven: promoting national ownership of strategies through broad based participation of civil society
- Result oriented: focusing on outcomes that will benefit the poor
- Compréhensive: recognizing the multidimensional nature of poverty
- Partnership oriented: coordinated participation of development partners
- Long term perspective for poverty reduction
Who was John Peters?
First director of the human rights division at the UN
What are the parts to the international bill of human rights?
- Universal declaration of human rights (adopted in 1948)
- International covenant on economic, social, and cultural rights (1966)
- International covenant on civil and political rights and its two optional protocols (1966)
What were some developments after then universal declaration of human rights?
Development of human rights conventions dealing with specific types of rights
Infomend human right being incorporations into the domestic legislation of many countries
Provided a strong basis for development of human rights international law
Development of an international criminal court
Greater willingness to intervene in other countries affairs for the sake of human rights
Define human rights
Rights of individuals simply because they are human, rights which are universal, collection of universally adopted principles founded on social justice and equality that consider freedom and well-being
Define civil rights
Rights of individuals to receive equal treatment and to be free from unfair treatment and discrimination, which may be protected by certain legal characteristics
Describe social justice
The desire for a well ordered society
The right to basic equal liberty and opportunities
Offices and positions that are accessible to all under fair and equitable conditions and opportunities
Social and economic disparities that benefit the least advantaged individuals
What is amartya sen capabilities approach?
Focus on individuals capability of achieving the kind of live they have reason to value
Claims that individuals can differ greatly in their abilities to convert the same resources into valuable functionings
Using income solely as a measure of inequality is insufficient
What a person actually has often matters less than what a person can actually do with what they have
Define legal rights
Entitlements that are enforced by the courts
Define moral rights
Entitlements that are not enforced by the courts but are influenced by historical, cultural, and moral consensus
What is a health indicator?
Variably that helps to measure changes in a health situation directly or indirectly and to assess the extent to which the objectives and targets of a program are being obtained
Measure human rights
What are human rights indicators?
Measure that provides information on the extent to which human rights norms and standards are addressed in a given situation
Measure health
What is meant by the right to health?
People have the right to basic health care services and interventions
Right to health not the right to be healthy
What are the most commonly reported issues with the right to health?
Availability: functioning public health and health care facilities
Accessibility: non-discrimination, physical, economic, information accessibility
Acceptability: respectful of medical ethics and culturally appropriate, sensitive to age and gender
Quality: scientifically and medically appropriate
What are the three types of state obligations?
Respect: not to interfere directly or indirectly with the employment of the right to health
Protect: prevent third parties from interfering with the right to health
Fulfil: adopt appropriate legislative, administrative, budgetary, judicial, promotional and other measures to fully realize the right to health
What occurs when conducting an analysis for a human rights-based approach to health?
Assessment: what is happening, where and who is more/most effective?
Causal analysis: why are these problems occurring?
Role/responsibility analysis: who has the obligation to do something about it?
Capacity analysis: what capacities are needed for those affected and those with a duty to take action?
Implementation: when and how can capacity development efforts produce the greatest results
What are some priority areas in the rights based approach to health?
Developing national plans which are closely monitored and include right to health indicators and pay particular attention to vulnerable groups
Strengthening health system governance, leadership, and accountability
Access to good quality, evidence based preventative, curative, and rehabilitative services, and referral networks
Access to care should be based on need
Investing in health to reduce poverty
What are the fundamentals of participatory action research?
Emphasizes participation and action
Seems to understand the world by trying to change it, collaboratively and following reflection
Emphasizes collective inquiry and experimentation grounded in experience and social history
Promotes an explicit sharing of power unusually in traditional research formats
What is PAR?
Seeks to understand the world by trying to change it, collaboratively and reflectively
Emphasizes principles of collective inquiry and experimentation grounded in experience and social history
What is a CBR matrix?
Community based rehabilitation matrix
Helps structure the consultation process
Five top cells: health, education, livelihood, social, empowerment
What is the MEL matrix?
Monitoring, evaluation, and learning matrix
Looks at the stakeholders involved and their engagement indicators, process indicators, expected outcomes, and unexpected outcomes
What are some challenges to PAR?
Getting research funds Getting through ethics Recognizing a variety of expertise Putting more time in intially Misconceptions around scientific rigour Occasional publishing issues
Define sex
Biological and physiological characteristics that define men or women
Determined by genetics
Male or female
Define gender
Socially constructed roles, behaviours, activities, and attributes that a given society considers appropriate for men and women
Define gender equality
The absence of discrimination on the basis of a persons sex in opportunities, allocation of resources or benefits, and access to services
Define gender equity
Fairness and justice in the distribution of benefits, power, resources, and responsibilities between men and women
In low income countries who are more likely to report ill health?
Women are more likely to report ill health
Why do men tend to live shorter lives?
Estrogen protects women against heart disease until later age
Men are more likely to be successful at suicide though women more likely to try
Men do more high risk activities
Men more likely to die from alcohol or drugs
More likely to smoke
Less likely to access public health services or use preventative medicine
Marriage is a protective factor for women
What kinds of illness are women more likely to experience?
Experience more frequent illnesses and disabilities but these are not typically life threatening, also gave some unique biological risks
Get hit later with more disabilities
What diseases are men more likely to be hit with?
More life threatening, more permenent disability, and more earlier deaths
What social determinants are men more likely to see?
Exposure to occupational risks
What social determinants are women more likely to see?
Poor Malnourished Domestic and sexual violence Preference for male babies Reduced access to paid work Illness and death more associated with their living conditions
What are some common barriers to health care experienced by men?
Sign of weakness to get help
Cannot take time off work as might be prédominent break winner
What are some common barriers to health care experienced by women?
Responsible for more caregiving tasks so too busy to get help
Less control over resources to pay for health care
Might need to be accompanied by another individual
What is reproductive health?
Concerns the reproductive processes, functions, and systems at all stages of life
Aim to assure that people are able to have a responsible and safe sex like, and that they have the capability to reproduce and the freedom to decide when and how
What are some examples of sexual health services and family planning?
Family planning counselling and education
Prenatal care
Safe delivery
Prevention and management of abortion and miscarriage
Treatment of reproductive health conditions
What is natural fertility?
When women or couples do not vary behaviours that affect their chance of subsequent birth, including birth intervals
What is controlled fertility?
When women/couple behaviour influences the interval to the next live birth
What are coale’s preconditions for fertility limitation?
- Willing: Acceptable of the possibility and moral acceptability of control of fertility
- Ready: perception of advantages from reduced fertility
- Able: knowledge and mastery of effective techniques of fertility control
Define contraception
Prevention of contraception/pregnancy through the use of drugs, devices, and sexual practices
What are some modern contraceptive methods? Traditional?
Modern: have been developed through modern technology or medical research (sterilization, the pill, condoms, injectables, etc)
Traditional: used to limit fertility historically, often with the use of more natural methods (eg. Rhythm method, withdrawal, douching, abstinence)
Define birth interval
The amount of time between one live birth and the next
What birth interval does WHO recommend?
2 years
Should wait 6 months after attempting pregnancy after having miscarriage or an induce abortion
How long does who recommend women breast feed?
2 years
Should exclusively breastfeed for first 6 months
Option in lower income countries is formula but most water is dirty
What is an obstetric fistula?
Hole between vagina and bladder caused by prolonged obstructed labour, leaving a women incontinent of urine or feces or both
Babies head putting pressure on the birth or vaginal canal
Can go on for 6-7 days
Lots of stigma associated with problems like this
What are some strategies used to address the issues of unwanted/unplanned births?
Abortion/induced abortion Sex-selective abortion Infanticide Foster age Adoption Abandonment
What is female infanticide?
Intentional killing of a baby girl due to the lower status associated with the birth of females and a preference for males
Shifted the gender ratio in some regions
More likely seen in low income regions
High income groups more likely to engage in sex-selective abortion
Why does sex selective abortion occur?
Distorted construction of girls being inferior
Family desire to sustain family name
Avoidance of paying a Downey
Expenditures of females are viewed as a waste because women will marry and leave
What is female genital mutilation?
All procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons
What are the different types of FGM?
- Partial or total removal of the clitoris and/or the prepuce
- Partial or total removal of the clitoris and the labia minora with or without excision of the labia majora
- Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositionjng the labia minors and or the labia majora with of without excision of the clitoris
- Unclassified
What are some complications of type 3 FGM?
Immediate: severe pain, extreme bleeding
Usually preformed in girls under 15, most often between ages 5-7
Can result in infection and fever, swelling, wound healing issues, shock and death
Long term: men’s real problems, vaginal problems, increased risk of birth complication
What is deinfibulation?
The practice of cutting open the sealed vagina in a women who has been infibulated to allow for sexual intercourse or to allow for child birth
What are some examples of violence against women across the life span?
Prenatal phase: abortion, bartering, coerced pregnancy
Infancy: infanticide, abuse, differential access to food and medical care
Childhood: FGM, sexual abuse, differential access to food, medical care, and education, trafficking
Adolescence: dating violence, sexual abuse, rape, sexual harassment, forced prostitution, honour killing
Reproductive: intimate partner violence, martial rape, partner homicide, spousal abuse, sexual abuse and harassment in work place
Old age: abuse of widows, elder abuse
Why is FGM preformed?
Helping girls save virginity
Prevent adultery and rape
Fight against female homosexuality and masturbation
Allow women to take part in social and cultural community
Ensure the girl is good to marry
Clitoris is not very present looking
Rumours that liquid from clitoris kills sperm
What is the UN definition of children?
Persons under 14 years of age
Often defined as persons under 18
What are the statistical definition of children and adolescent?
Adolescents are 10-18 Teenagers are 13-19 Youth are 15-24 Young adults are 20-24 Perinatal: first week Neonatal: first month Infant: first year
What are some causes of death among young children globally?
Diarrhea Pneumonia Asphyxia Sepsis Tetanus Pertussis
What is asphyxia?
A condition of severely deficient oxygen supply that may lead to damage of the brain, heart, lungs, and other organs of death
What is sepsis?
A condition causes by a severe infection leading to a systemic inflammatory response that can damage organ systems
What are the top 3 causes of death in kids under 5 globally?
Premature
Acute lower respiratory infections
Birth asphyxia and brain trauma
Describe the who/UNICEF framework for pneumonia and diarrhea?
Protect: establish good health practices from birth
Prevent: vaccine, hand washing, safe water, reduce household air pollution, HIV protection
Treat
What are some contributing factors of child vaccination
How do you get the vaccine to the children
Do you have enough health care providers to deliver vaccines
What is child labour?
Often defined as work that deprives children of their childhood, their potential and they dignity, and that is harmful to physical and mental development
Economic participation by children
Full time work preformed by children
All paid work preformed by children
Work that interferes with children’s well-being and participation in child appropriate activities
Work that is harmful to or exploits children
Work that violates national child labour laws
Work that violates international standards
What are some positives to child labour?
Feel like fair and reasonable way to provide for their family
Might keep them busy or get them out of a bad home
Helping gain future indépendance
Assisting with household task, participating in family business outside school hours are not considered bad
As long as it is in moderation and does not interfere with school
Where are most working children concentated?
Africa and Asia
152 million children are still engaged in child labour almost half in its worst form
What are the unconditional worst forms of child labour?
Violations of already existing human rights standards
Ex. Child slavery, forced or bonded labour, child trafficking, prostitution, pronography, child soldiers
What is unresolved worst forms of child labour?
Harmful to health, safety, physical, mental, spiritual, moral, and social development of children
Often defined through the application of theories of child development
Ex. Work in dangerous environments, long work hours
What are some facts about children and education?
Half of 58 million out of school children of primary school age live in conflict affected areas
More than one in four children in developing regions entering primary school is likely to drop out
What are some characteristics of child labour?
More prevelent in low income countries
Mostly takes place within the family unit
5-11 form the largest share of those in child labour and a substantial share of those in hazardous work
Boys appear to face a greater risk of child labour that girls
Girls more likely to shoulder responsibilities for household chores
What are the three areas of hold labour?
Agriculture (70.9%)
Services (17.2%): retail trade, restaurant, hotels, transport
Industry (11.9%): construction, manufacturing, mining, public utilities
What are some health effects of child labour?
Physical hazards: violence, injuries, impact on growth
Chemical: exposure to metals or contaminants in waste, nausea, headaches, weakness, reproductive issues, diseases
Cognitive: motor intelligence, memory, impacts school performance
Behavioural: mature quickly, sense of loss, risk of emotional abuse
Psychosocial: abusé, poor living conditions, violence, no friends
Community effects: contamination to home and water supply, impact of HIV/AIDS, more likely to smoke
Why are the health effects of labour hard to measure?
Selection bias as you are picking children healthy enough to work
Might be a long latency period before health effects are actually noticed
Might not get adequately reports or connected to child labour
Under recognition or report of problems
Has child labour increased or decreased since 2012?
Decreased most places except sub-Saharan Africa where it increased
What is the youth bulge?
Large share of the population comprised of children and young adults
Due to a stage in development where country achieves success in reducing infant mortality but mothers still have high fertility
One basic measure of a country’s success in turning the youth bulge into a demographic dividend is the youth (un)employment rate
What are some advantages and disadvantages of the youth bulge?
If have good policies and can employ and train these people, have opportunity for growth
If not, nothing good happens
Has been described as demographic bomb
Source of both social and political instability
What is the demographic dividend?
Occurs when the size of the working age population is high relative to the size of the dependent age populations
When can the demographic divide result in a potential for a high level of economic productivity?
- There are jobs to productively employ the working age population
- We capitalize on the relatively small number of dépendant children by undressing education attainment
What is dependency ratio?
Ratio of non-working age population to the work age population
What dividends can universal primary education and expanding secondary level enrolment yield?
Improving skills for productive employment
Reducing risky health and social behaviours
Developing positive health behaviours and habits
What gender knows less about their body?
Women seem to have less of an understanding of how things work and what the risks are
What are the top three causes of death in adolescents globally?
Road injury
HIV/AIDS
Self-harm
What are the leading causes of DALY’s in adolescents world wide?
Depression
Road injury
Anemia
HIV/AIDS
What are some issues with adolescent sexuality?
Early sexual debut has been linked to infertility especially when more than one partner, major cause of infertility is STI’s
Has been linked to higher likelihood of the use of coercion or force than when sexual activity begins at older ages
Describe the state of maternal conditions in adolescent health
16 million girls aged 15-19 give birth every year
3 million girls aged 15-19 undergo safe abortions every year
Adolescent girls who give birth are at increased risk for birth complications, infant, and maternal mortality
How are mothers age and child health linked?
When first born child is born to a young mother (12-20) than the child is at greater risk of dying before age five, being stunted, being underweight, and suffering from anemia compared to mothers 24-26
What countries have the 3 highest rates of child marriage?
Niger
Central African Republic
Chad
What are the top 3 countries with child brides?
India
Bangladesh
Nigeria
What do the demographics tell about girl marriage?
Girls with higher levels of education are less likely to marry before age 18
Poorer households are more likely to marry off girls before age 18
Girls in rural areas are twice as likely to marry before age 18
What are some thin impeding girls use of health care services?
Adolescent: embarrassment, ignorance, fear
Families: low position of girls, lack of health knowledge, poverty, low priority of sexual and reproductive health
Providers: judgemental attitudes, inability to talk/listen/treat adolescents, legislative restrictions
Facilities: non-availability, overcrowding, long wait times, low priority and insufficient funds
What is the alma-ata declaration?
Major milestone of the 20th century
Highlighted issues around primary healthcare for all
Attainment of a certain degree of health is a fundamental human rights of individuals
Fundamental worldwide goal that should be realized
Multiple stake holders required
First international declaration underlining the importance of primary health care
What are some issues with health systems and economic growth?
Lower income countries will see great benefit from investing in some very basic interventions such as hygiene sanitation, immunization, and bed nets
Higher income countries require more long term complex management
How has globalization effect health systems?
The exchange of technology
How we share advanced knowledge and pharmaceuticals
Brain drain
Health info sharing online
Define primary care
First contact care
More basic levels of health care
Deals with majority of health care issues
Countries that have strong primary care framework tend to do better
Provides entry to healthcare systems
What are some characteristics of primary care?
Evidence based medicine
Universally available
Affordable
Address the actual needs of the community
Provide preventative care, curative care, and rehabilitative services
Should be linked to more advanced levels of health care through a referral system
Define secondary care
Medical care provided by a specialist or a facility upon referral by a primary care physician
Define tertiary care
Soecialized consultative care, usually on referral from primary or secondary medical care personnel, by specialists working in a center that has personnel and facilities for special investigation and treatment
Ex. Cancer care center
What is unique about Cubas health care system?
Made a lot of investment in health care
Implanted in early 1970s
Provide over 20 services
Focused on rural medical services by making it part of training
Define health systems
All the activities whose primary purpose is to promote, restore or maintain health
Address environmental factors with the intent of improving health
Excludes activity whose goal is not health even if it enhances health
What are vertical approaches to global public health? What should it be?
Public health initiatives targeted at addressing a single disease/health condition at a time
Provide a solution to a single problem
Desirable if your template of health care is very weak, need to address something quickly, very specific target group that is hard to reach, need very highly skilled people (surgery)
Should be time limited, avoid negative spill over effect, try to bridge two approaches
Ex. Small pox eradication
What is the horizontal approach to global public health?
Public health initiatives focused on integrated delivery of general health services and tackling overall health problems
Aim is to develop health networks that cater to people’s day to day health issues
Broader in nature
Integration of general health services to address multiple issues
What is changing the nature of healthcare globally?
Development of pharmaceuticals
Technological advancements
Surgical advances
Treatment of non-communicable diseases
What are global health systems?
Group of actors whose primary intrant is to improve health, along with the rules and norms governing their interactions
Organized social response to health conditions as the global level
WHO is probably only real actors because it is built on universal membership
Key concept is understanding the pattern of health conditions is the international transfer of health risks
What is the global governance of health?
The way in which the global health system is managed
No governance at global level
What are the four essential functions of the global health system?
- Production of global health goods:
- Management of externalities across countries: surveillence and information sharing + coordination of preparedness and response, mitigating negative health effects of certain situation
- Mobilization of global solidarity: development financing, humanitarian assistance, mostly through provision of aid
- Stewardship: government
What were the three measures of health performance in the world health report?
- Health attainment: how system improves or protects people’s health, how long can you live in good health
- Responsiveness to the expectations of the population: goals of the health system to reduce inequalities in a way that looks at improving the situation of the people that are worst off
- Fairness of financing whether the health care system does anything to reduce the out of pocket experiences when it comes to paying for health care
What were the four functions of health care according to the 2000 world health report?
- Providing health services
- Generating human/ physical resources for service delivery
- Raising/pooling resources to pay for health services (financing)
- Stewardship
What are the LINHs?
Local health integration networks
Created by Ontario to plan fund and integrate health services for more efficient care in this regions
14
Able to reach populations and people more easily
Funded by ministry of health and long term care
What are the top 3 most expensive health care systems?
US
Switzerland
Germany
What are some ways to make a good health care system?
Taxation and payroll
People who are better off need to subsidize for those poorer
Spending of public funds in the favour of poor individuals
Need to train people and have good place to work
What are the top 3 use of funds by Canada in 2014?
Hospitals
Drugs
Physicians
What are the system building blocks for the WHO framework?
Service delivery Health workforce Information Medical products, vaccines, technologies Financing Leadership/governance
Define allopathic or conventional medicine
Richer the country, more in trenches in allopathic if convention medicine it is
More positive health status indicators such as lower infant mortality
Describe complementary and alternative medicine
Common in many developing countries
In low income countries CAM is likely to be used by both low and high income countries
In higher income countries CAM is more likely to be used by high income women
What is the goal of universal health care?
Ensure that all people obtain health services they need without suffering financial hardship when paying for them
Talk about user fees
Generally considered bad and should be dropped especially for people on lower end
Can’t be eliminated completely, reduced to a point where they are not a huge burden
Talk about sliding scales
Paying based on socioeconomic status
People able to pay are subsidizing people on lower end
Talk about out of pocket expenses
Should try to keep them to a very minimum level so as not lose a burden
Considered to be regressive in nature
People will appreciate what they are getting if they are still there but small
What are some health sector issues?d
Demographic and epidemiological change Inaccessible/inéquitable care Quality of care/unsafe care Misdirected care Fragmented care Inverse care Stewardship Human Resources
What are some components of health sector reform?
Improving performance of civil services Decretralozation Improving function of health ministries Building the health financing options Introducing managed competition Working with the private sector
What is WHO?
Directing and coordinating authority for health within the UN
Addressing health related issues across the globe
Responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence based policy options, providing technical support to countries and monitoring and assessing health trends
What are the current who priorities??
Universal health coverage
International health regulation
Increasing access to medical products
Social, economic and environmental determinants
Noncommunicable diseases
Health related millenium development goals
What is unicef?
Protects the rights of children
Believe all children have a right to survive, thrive, and to fulfill their potential to the benefit of a better world
Lot of activities focus on social determinants of health
Include child protection and inclusion, child survival, education, emergencies, gender, innovation for children, supply and logistics, and research and analysis
What is the Red Cross?
Humanitarian network/organization
Ensures people affected by conflict or disasters can get basic healthcare that meets universally recognized standards
May involve assisting services already in place or replacing them altogether temporarily
Created in 1863
What are the 7 fundamental principles of the Red Cross?
Humanity Impartiality: no discrimination, based solely on need Neutrality Independence Voluntary service Unity Universality
Describe the Canadian Red Cross
Often involved in home care and providing care in the community
Community support services that they provide to assist people living independently in their home, health equipment loan program, and home care services
What is doctors without boarders?
Goal to help save lives and ease suffering of people in acute crises
Provide a range of services including basic vaccination services, maternal and pédiatric care, neglected diseases, and complex surgeries
High quality of medicine for poorest people
What is USAID?
Goals are ending extreme poverty and promoting the development of resilient, democratic societies that are able to realize their potential
Look at providing more technical support (infrastructure) and socioeconomic development
Food security, access to education
What is the bill and Melinda gates foundation?
Established in 2000
Does not fund direct donations to individuals specifically, projects that exclusively serve religious purposes, political campaigns and legislative lobbying efforts
Aims to harness advances in science and technology to save lives in developing countries
What is the Clinton foundation?
Operating foundation meaning that money raised by them is spent directly on their programs
Do not provide grants to other organizations
Health access initiative that focuses on addressing the HIV/AIDS issue in developing countries and to help strengthen their health systems
What is the Rockefeller foundation?
Established in 1913
Goal to promote the wellbeing of humankth throughout the world
What is the Bloomberg philanthropies?
Combat the widespread health hazards by spreading proven solutions to protect more people
Established in 2006
What is the aga khan foundation?
NGO established in 1967
Focus on health but also on development
Small number of specific development problems by forming intellectual and financial partnerships with organizations sharing its objectives
Help educate people and avoid illness altogether
Implement income generating activities
Operate one of the largest non for profit private healthcare systems in the world that includes basic health centres
What is the global fund?
Focuses on 3 most prominent infectious diseases
Prevent and treat those diseases
Most of money comes from high income countries
Basically a financial institution that provides money and support to countries to address these three diseases
Not actually implementing programs on the ground
What is OECD?
Organization for Economic Co-operation and Development
Focus on development related initiative
Mix of powerful and emerging countries
What is the bretton woods institutions?
Own the international monetary fund and world bank
What is the world bank?
Provide low interest loans, zero to low interest credit and grants to developing countries
Okay time in strengthening poverty reduction strategies
What is the International Monetary Fund?
Help ensure stability in the international system by keeping track of the global economy and the economies of member countries, lending to countries with balance payment difficulties, and giving practical help to members
What determines if an infection becomes a spreading outbreak?
Sustained human to human transmission
Impact will depend on basic reproductive number (Ro)
What is basic reproductive number?
Number of subsequent individuals infected by an infected individual
Ex 1 = for every 1 individual who has it, 1 person will get infected
Measles is 18
Goal is to reduce below 1
>1 = spreading infection
What are some strategies to tackle outbreaks?
Early detection: surveillance, reporting, identification of pathogen
Ground level containment: social distancing, anti-virals, vaccines
What are some requirements of a successful outbreak control?
Local and international public health capacity
Laboratory and vaccine/pharmaceutical capacity: examine and identify + produce treatment
Domestic and international surveillance systems: garentee cases are reported
Domestic and international governance systems
What are some changes in the influenza virus?
Minor and seasonal changes: minor changes in A & B strains, same subtype every year while virus is in humans
Major changes: swapping of genetic material between avian/animal strains, produce new subtype with changes H and/or N, population has no immunity to this new virus
What are the different phases of WHO’s pandemic alert system?
Phase 1: no animal influenza circulating has been reported to cause human infection
Phase 2: animal influenza known to cause human infection, considered specific potential pandemic threat
Phase 3: animal or human-animal influenza causes sporadic cases or small custers but no human to human transmission
Phase 4: human to human transmission able to sustain community level outbreaks verified
Phase 5: same virus has sustain outbreaks in two or more countries in one WHO region
Phase 6: same virus causes sustained outbreaks in at least one country of another WHO region
What are the international health regulations?
Approved in may 2004
Prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restrict to public health risks, which avoid unnecessary interference with international traffic and trade
Trying to balance economy and health
What were some reasons for the revision of the international health regulations?
Limited disease coverage
Out of date technical/public health requirements
Compliance concerns
Excessive responses to some outbreaks
What were the major changes to the international health regulations?
New WHO powers: indépendant surveillance, unilateral travel recommendations
New requirements on countries: develop surveillence systems, report public health emergencies within 24 hours, develop response strategies
What are the steps to declaring an outbreak to WHO?
Notification of a potential public health emergency of international concern (PHEIC)
Creation of an emergency committee
Declaration of a PHEIC
Issuance of recommendations: enhanced surveillance, no travel restrictions
What are some measures used in Canada to mitigate the impact of outbreaks?
Vaccines
Antiviral for treatment and prophylaxis
Non-pharmacologic interventions: hand hygiene and physical barriers, isolating/social distancing, cancellation of public gatherings, school closures
What are the requirements for quatre time to work in disease control?
Long enough time from exposure to infectiousness
Low enough fraction of infection transmitted before onset of symptoms, or with asymptomatic infection
Low enough reproductive number
What is the emergencies act?
Provides federal government with authority to take action to address a national emergency
Under this act, and infectious outbreak is one of several categories of emergency considered as a public welfare emergency
Allows government to move people and take control of property and regulation of travel
What are some threats to multilateral approach to outbreak prevention?
Disincentives for poor countries to comply
- early detection primarily for the benefit of wealthy countries to allow them to take appropriate measures
- suveillance diverts money from more important public health threats (HIV, malaria, TB)
- reporting outbreaks can damage the economy
What are some ways climate change effect health?
Heat waves Floods and storms Water scarcity and quality Communicable diseases Air pollution Changing agriculture Migration (indirect) Insecurity (indirect) Economic effects (indirect)
Describe how global warming have affected floods and storms
More intense and frequent storms
Affects the poor disproportionately
Most poor people live on the water
How does global warming affect communicable diseases?
Might make more places habitable for mosquitos carrying malaria
Increased population growth and density means faster spread of such diseases
How does global warming affect agriculture?
Affects productivity, agricultural practices, environmental effects, rural spaces, and adaptation
Poor agriculture leads to poor nutrition leads to poor health
Synergistic effect: inability to produce food leads to food related diseases which leads to inability to participate in the economy and an inability to stop the problem
What are some important issues with climate change?
Poor countries cannot afford risk assessment
Global rush to cities is accseleratting this process
Global Issue that requires a global solution
What are some common characteristics of community from a sociological perspective?
Location/geographical proximity
Common ties
Social interactions
What do functions of a community include?
Give you a group to identify with
Allows for social interactions
Organization and structure so that you can actually do things together
What is community development?
Procès designed to create conditions of economic and social progress for the whole community with its active participation and fullest possible reliance upon the community’s initiative
What is civil society?
Array of social organizations representing diverse stakeholders
Strategic partner in the economic development and the fight against global poverty
What should international stakeholders consider in community development?
The degree to which local people rely on governments vs their own social networks to achieve their goals
The degree to which international cooperation may hinder community development
What was one of the first healthcare disciplines to consider community as an area of assessment, treatment, and service?
Nursing
What were some of the earliest public health initiatives m?
Immunization programs for children
Focusing on life threatening hygienic conditions
Looking at dangerous physical environments
What are some issues with community based health services?
May be in defunded and not easily accessible
Poor standards of care and unqualified or unregulated health providers providing inappropriate treatment
Distance and lack of financial resources
What are some ideal characteristics of community based approach?
Specific, sensitive, inexpensive, noninvajse and easy to use diagnostics
Safe, effective and inexpensive drugs that have a long shelf life, are easily to administer, and are easy to use for patients
Équipement and resources are easy to transport, maintain, etc
Define community oriented
Programs do not oroginate within the community but are brought in from some external source to meet the community’s needs, includes external human and financial resources
Define community-initiated
The idea and concept of the program are conveived within the community with the main goal being to meet needs that have not been met by conventional means
Don’t see these a lot
What are the typical parts of a community based program in a developing country?
Often begins with some stimulus external to the community that is interested in implementing a health/social program in the desired area
Persons affiliated with the external agency help to address local health, social, vocational and educational issues
Help train local people to work with community members to improve the conditions of the overall community
Describe the 4 steps in preparing community health workers?
- Recruit
- Train
- Equip
- Manage
- Pay
Help establish link between front line health care workers and other health facilities
Define community mobilization
The process of bringing together all intersectoral social allies to raise people’s awareness of, and demand for, a particular development programme, to assist in the delivery of resources and to strengthen the participation of people to achieve product sustainability and self relieve
What are the main principles of community participation?
Communities can and should determine their own priorities in dealing with the problems they face
Enormous depth and breadth of collective experience and knowledge in a community can be built on to bring about improvements
When people understand a problem, more readily act to solve it
People solve their own problems best in a participatory group process
Describe a community profile
Community demographics
Community social and health services dimensions (which services exist, which are lacking, factors to consider before implementation)
Methods to develop profile of community
What are the three key areas of a service profile?
Population, condition, and context
Allow you to look at which services already exist and whether there is other programs addressing this
May see many organizations working in an area not collaboration
What are Bradshaw’s four types of needs?
- Normative needs: defined by experts
- Expressed needs: inferred from observation
- Comparative needs: may be similar to another location
- Felt needs: voiced by community members
What are the two phases of needs assènent?
Phase 1: determine the needs of targeted population from perspective of those who may be involved with population at some level ex. Health care professional, teachers, etc
Phase 2: assess the perceived needs form the perspective of the target population themselves, may include more focused interviews and questions
Define program evaluation
A system that provides information about a programs effectiveness and ability to meet the desired outcomes
Includes needs assessment, evaluation of process, efficiently and effectiveness, impact of the program, individual satisfaction, research endeavours, out come evaluation
What is an outcome evaluation?
Method of evaluation that focuses on the results of programs, services, or intervention strategies
What is a formative evaluation?
Occurs at jntervals throughout the program in order to asses participant progress and the programming progress
Define summative evaluation
Occur at the end of the program cycle (can be coupled with formative evaluations)
