Health Systems Flashcards
Give the WHO’s definition of “Health”
A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity
Define Public Health
Public health is the science and art of preventing disease, prolonging life and promoting health through organized efforts of society
Define Health systems
- The ensemble of all public and private organizations, institutions and resources mandated to improve or restore health
- Health systems encompass both personal and population services as well as activities to influence the policies and actions of other sectors to address the social, environmental and economic determinants of health
How are public health and health systems linked?
Define the term well-being
The state of being comfortable, healthy, or happy
Give examples of elements of well-being
- Environmental quality, Social connections
- Personal security, Civic engagements and governance
- Jobs and earnings, Income and wealth
- Health status, Housing
- Subjective well-being, Work-life balance
- Education and skills
Give examples of elements of happiness
- Social support
- Life expectancy
- Freedom to make life choices
- Generosity
- GDP per capita
- Perceptions of corruption
What is the human right to health?
- 1948 The right to health was first proclaimed in the preamble of the WHO Constitution
- 1948 in Article 25 of the Universal Declaration of Human Rights
- 1976 in the International Covenant on Economic, Social and Cultural Rights entered into force, reaffirming in its Article 12 “the enjoyment of the highest attainable state of health as a human right under international law”.
What are the Determinants of life expectancy at global level?
- Poverty and wealth
- Clean water/sanitation
- Shelter/housing
- Nutrition
- Low physical activity
- Education
- Tobacco and alcohol
- War and conflict
- Climatic/ecological circumstances
- Health care, especially preventive care
What are the Changing expectations of health systems-pressures for reform?
- Demography-the increasing proportion of the old and the very old
- Co-morbidities amongst the old
- Technological advances-diagnostic, therapeutic, pharmaceutical
- Raising population expectations for quality care
- Litigation pressures
- The increasing involvement of public institutions and financing
- Pressures for quality, efficiency and cost-control
Describe the mechanisms for the public funding of care
- “Single payer” tax-based general revenues-provide care directly through state-owned and run facilities e.g. the UK, Canada
- Possibility of earmarked (hypothecated) health tax
- Social insurance financing e.g. Germany, France
- Individually based insurance e.g. United States
- Support health care consumers directly through “vouchers”
- Health savings accounts plus catastrophic insurance
What caused the market failure in health care?
- Consumers not “sovereign”
- Little consumer-based information-asymmetries of knowledge
- Difficult to understand complex health field
- Needs often acute and price inelastic
- Health expenses may be sudden and financially overwhelming
- Dependence on providers
- Demand not constrained by private purchasing power-inflationary
Define primary health care
The term primary (medical) care ….stands for those medical services to which people have direct access and in contrast with secondary care services normally reached by referral (meaning second or tertiary level specialist services
How did the WHO director general describe PHC?
a PHC–based health system entails an overarching approach to the organization and operation of health systems that makes the right to the highest attainable level of health its main goal while maximizing equity and solidarity
What is the ideal role of community health centre?
- The prevention and treatment of common diseases, injuries, basic emergency services;
- Referrals to and coordination with other levels of care that include:
- Hospital and specialist care, primary mental health care, palliative care, health promotion, healthy child development, primary maternity care and rehabilitation services;
- On-call services around the clock;
- Availability of essential drugs;
- Laboratory services;
- Disease screening for communicable and non-communicable diseases;
- Tele-health services via real-time telecommunication, tele-consultation, information dissemination, and video conferencing support amongst physicians and different healthcare professionals.
- Supervise the Community Health Posts
What is the oft seen situation in limited income countries?
- Health status is unacceptably low across in many countries, in particular in Sub-Saharan Africa but pockets of ill-health and extreme poverty in all regions
- Socio-economic status of great importance to health experience
- Effective prevention, cure or treatment and relevant technologies are well known for most of the burden of disease
- Necessary focus of primary health care, and promotion and prevention
- At the centre of this crisis is the failure of health systems
List the key issues in limited income countries
- Finance: chronic under-investment
- Human resources: the acute crisis in Africa
- Information deficiencies
- Shortages of vital commodities and supplies
- Poor health governance
- Equity issues: access to quality care not only to the elites
- The aid architecture debate in health: horizontal and/or vertical
