global health Flashcards
global health
understanding and promoting of health in intercultural and interdisciplinary context
dont have to cross boarder, can cross interculturally in 1 country
study, research, health care practice with focus on improving health and health equity for pop worldwide
global health: goal
improve health for all people in all nations by promoting wellness, eliminate avoidable disease, disability, death
global healthcare delivery: current and historical harms
superior or enlightened people provide charitable care (usually N -> S)
usually without acknowledgement r/t colonial past: N contributes to economic disempowerment of countries and people
some med missions
hc as religious condition
colonial perspectives
-> people cant solve own issues
great white hope/white saviorism
service his children/savior complex -> unqualified people providing care
ideal: decolonize hc
stress commonality of humanity, approach to health needs to be partnership based (collective)
accompaniment and solidarity: work with colleagues and social justice as core hc component, partner with comm, don’t supersede, make sure you are wanted, check your motives
diarrhea and leaky bucket
doll
oral rehydration salts
increase or decrease fluids?
implementation science:
17 years to widely adopt ebp -> people dont study/understand vocal context, dont partner/engage with comm or intended audience, study in vacuum/controlled env and difficult to translate and sustain real world (lab, paid)
partners in health 5 S’s to strengthen health systems
staff: trained, enough
stuff: tools and resources
space: appropriate, w/ capacity
systems: leadership, gov, info, finance
social support: basic necessities and resources needed for effective care
nursing: benefit to self
cross cultural adaptability
bidirectional: low cost innovations, hc rationalizing, global health equity, minimize waste/env impact
grad degrees and certificates
nursing: benefit to others
assure ebp, disseminate value or well edu nurses
advocacy: health for all, cost effective and accessible
fill gaps: ap role, research, specialty care -> have supplies but maybe no training to use
evolution
people can solve own problems with paradigm shift through social and economic dev
global health organization
UN: depend on political will of member states to have decisions put into action, relies on contributions of member states to carry out activities
created WHO: responsible for global health, funded by members and private donors, sustainable dev goals: r/t poverty decrease, measure and improve SDOH and wellbeing
alma ata
goal, ambitious, not met
assess and address social and structural inequities
change the way we pay
transform society by realigning policies: invest in primary care, center health equity on value based payment, include sense of place (shift from consumer service to comm service)
geographic empanelment
rec primary hc to begin at house and serve 50 square block, people feel like they own it
in us, public doesnt talk to private
feed upwards if need more care
why US care about global health
protect residents
humanitarian obligation
broader mission of foreign policy -> peace and security, strengthen image of US
refugee resettlement in US
US gov contracts with local organizations
KY provides 3 mo support: housing, job, english, cash
refugee
person who must leave homeland d/t persecution of beliefs, race, ethnicity
displacement: usually wait max 10 years, few ever resettle, some go back home
vetting: highest level of security checks, most of this happens outside US
trauma
before: violence, witness death or serious injury
during: conditions, assault, kidnap, trafficking
after: uncertain, fear of deport, chaotic living, poverty, lack of social support
major migrant/refugee health challenges
no access to hc: insurance not avail, lang and cultural barriers, no info
r/o communicable disease: d/t living conditions, no coordinated hc, limited access to vax
interruption of care for chronic health problems
food insecurity and related nutritional problems
limited access to sexual and reproductive health services: prenatal care -> poor preg outcomes
global health data and comparisons
determine what is not working: learn = prevent and improve health, ID what to invest in or prioritize to improve health and health equity
measure health at pop level -> global burden of disease
global burden of disease
tool to quantify health loos
health systems improve and disparities decrease
incorporate prevalence of disease or rf and relative harm it causes
compare effects of different diseases: prioritize prevention, research, funding
global leading COD
ischemic HD
stroke
COPD
d/t lifestyle, non communicable
low income leading COD
neonatal conditions
lower resp infections
ischemic HD
communicable
high income leading COD
ischemic HD
AD and dementia -> not living long enough in other countries, age adjust
stroke
hc systems: compare to US
spend 2x as much, avg 76.4 yrs compare to 82.3 for other high income
we do well in: cancer survival, MI and stroke survival, medicate chronic diseases, research
top countries
access, care process, admin efficiency, equity, hc outcomes
noway, netherlands, australia
4 distinguishable features:
universal coverage, remove cost barriers
invest in primary care systems to ensure equitability
decrease administrative burdens that divert time, effort, spending from health improvement
invest in social services: esp children and working adults -> cheaper if invest early
disability adjusted life year (daly)
lower = better
1 dally = losing one year in good health d/t premature death, disease, disability
account for morbidity/suffering
daly = YLD + YLL
yld = yrs live with disability
yll = years of life lost
