Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Global Health BSc 2018/19 - GHG > Health Systems - 2.2-3, 2.8, 2.9-10, 2.16 > Flashcards

Health Systems - 2.2-3, 2.8, 2.9-10, 2.16 Flashcards

1
Q

What is the definition of a health system?

A

The sum total of all the organisations, institutions + resources whose primary purpose is to improve health

‘The essence of a satisfactory health services is that the rich and poor are treated alike, that poverty is not a disability and wealth is not advantaged’ (Aneurin Bevan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the fundamental objectives of a health system? (x5)

A

Improve health status of indiv, families + communities
Defend population against what threatens its health e.g. outbreaks
Protect people against the financial consequences of ill-health
Provide equitable access to people-centred care
Enable people to participate in decisions affecting their health and the health system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 6 building blocks of the WHO health system framework?

A 
FILMS H
Finance
Information
Leadership/governance
Medical vaccines, devices + technology
Service delivery
Health workforce
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 4 outcomes of the WHO health system?

A 
SIRI
Social + financial risk protection
Improved efficiency
Responsiveness
Improved health (level + equity)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What 4 things allow the WHO building blocks of a health system to achieve the outcomes?

A

Access
Coverage
Quality
Safety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is important about the building blocks that enable an effective health system?

A

It is not the building blocks alone that make a health system. It is the multiple relationships and interactions between the blocks and what converts it into a health system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 4 different types of health system financing models?

A

Beveridge
Bismarck
National Health Insurance Model
Out-of-pocket model

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the Beveridge model?

A

Healthcare provided + financed by government through tax payments
Not all hospitals owned by government though
Insurer is state
Low costs per capita

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What countries adopt the Beveridge model?

A

Great Britain, Spain, most of Scandinavia + New Zealand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the Bismarck model?

A

Private provider and private payer
Entitlement bases - contribution
Wages = funding base
Occupational ‘insurer’ - sickness funds from employee AND employer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What countries adopt a Bismarck model?

A

Germany, France, Belgium, Japan, Switzerland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the National Health Insurance Model?

A 
Private provider
Public/government payer
Citizenship/residence funding base
Occupational 'insurer'
Public funding accounted for an estimated 70% of total health expenditure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What countries adopt the National Health Insurance model?

A

Canada, Taiwan, South Korea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the out-of-pocket model?

A

Private provider + private payer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What countries adopt the out-of-pocket model?

A

LICs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which is the best health system finance model?

A

Context-dependent
Each country has a different starting point + context, so the right “next steps” to improve efficiency + sustain performance will differ - principle/impact driven

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the negative impacts of conflict on public health and health systems? (x5)

A 
Loss of lives
Worsening malnutrition
Internally displaced people and refugees
Communicable disease spread and may become life threatening 
Chronic illnesses aren't treated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What do governments of a fragile state lead to? (x4)

A

Governments cannot provide basic services for citizens
Lots of mistrust exist
No economic opportunity for citizens
Hard to rebuild

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the key principles of post-conflict rehabilitation of the health sector?

A

(Refer to the star diagram)
Bottom left quadrant indicates immediate help is needed - bypass government + service delivery
Top right quadrant refers that government partnership + system strengthening is needed for sustainable development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the 3 key phases to rebuild a healthcare system?

A

1) Initial response to immediate health needs e.g. urgent aid, data collection, emergency care
2) Restoration/establishment of a package of essential health services e.g. EML, antenatal care, vaccines, HIV/TB services
3) Rebuilding health system itself e.g. WHO 6 building blocks of health system (FILMSH SIRI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Name 4 frameworks + tools for Health System evaluation (+ monitoring)

A

The Health System Function Approach (WHO 6 Building blocks)
The ‘control knobs’ framework - Roberts et al., 2004
SWOT analysis
Logical Framework approach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Give a case study whereby a health system had to be rebuilt.

A

Libya 2012

WHO Collaborating Centre was asked to carry out an in-depth assessment of Libya’s health system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What were the aims of the assessment of Libya’s health system in 2012?

A

Identify gaps + shortages
Identify challenges + opportunities for health system reform
Identify future directions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What did the 2012 Libya health system review involve?

A

In-depth desk review
Field visit
Interview with key informants + stakeholders
Led to 2 reports

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What were the main challenges found in the Libya health system review in 2012?
``` Lack of data + evidence Low quality of care Shortage of primary health care facilities Chronic need for maternal + antenatal care Need for mental health services High numbers of 'treatment abroad' Prevalence of HIV drug-injecting users Ambiguous MoH policy ```
26
What were the strengths found in the Libya 2012 health system review?
``` Commitment Drive for development Finance availability Workforce (production at lower end) Support of international community ```
27
What were the 'quick wins' - results that will build credibility with key stakeholders - found in the Libya 2012 health system review?
Primary health care Medicines - availability + distribution Income incentives - salaries to work in rural areas Communication strategy - public's confidence in health services was at its lowest
28
What were the 'must do' actions the Libyan government was advised to take in 2012?
Create a Public Health body at MoH Focus on leadership training Establish updated Public Laws + Regulations Develop a Master Plan - all stakeholders should operate within its frame
29
What is universal coverage?
Ensure that all people have access to needed health services (promotive, preventive, curative + rehabilitative) of good quality without the risk of financial hardship linked to paying for care Worldwide ideal advocated by WHO
30
What are the 4 main goals of a health system?
Improve health Provide financial protection Support fair financing (ability to pay vs risk of ill health) Responsive to people's legitimate expectations
31
Describe the inequities in health care access between rural + urban populations
WHO report 2000: Major urban hospitals receive around 2/3 government budgets but only serve 10-20% population Isolated communities have fragmented + under-resourced care Urban populations have better continuum of care Depends on population movement in countries e.g. Canada is huge so rural is poor but there is trend of urbanisation
32
What are the reasons for good access to health care in urban areas?
Hospital dominated/specialist care Diverse care services/good referral services High levels of private care services (unregulated fee charging)
33
What are the reasons for poor access to healthcare in rural areas?
Regional + cottage hospitals + health centres Fragmented care approach based on individual disease control Limited resources, no continuum of care
34
What are the 4 components of effective access to healthcare?
4 A's Affordability - ability vs willingness to pay Accessibility - convenience to access, waiting times, appointments, time to travel Acceptability - needs for minority groups e.g. LGBTQ+ Awareness - increasing knowledge about services available +/- changing behaviour
35
What are the 3 types of barriers to access of health care in isolated indigenous populations such as in Guyana, S America?
Health system Physical Economic
36
What are the health system barriers of access to healthcare in Guyana?
Shortage of healthcare providers Poor facilities + limited supplies Lack of emergency response services Fragmented service + no continuum of care Overlapping personal + professional roles
37
What are the physical barriers of access to healthcare in Guyana?
Long travel distances/impassable roads in rainy seasons Lack of public transport/expensive Limited telephone + internet services User's fees
38
What are the economic barriers of access to healthcare in Guyana?
Limited economic resources - income + insurance Adverse + unpredictable weather conditions Threats to confidentiality + privacy Local values + beliefs
39
What are the current strategies in remote areas?
``` District/cottage hospitals Static health centres Outreach clinics Health huts/posts Community Development Workers (CDWs) Mobile units (single disease control) ```
40
What is the definition of globalisation?
Historical process characterised by changes in nature of human interaction across range of social spheres incl economic, political, technological, cultural + environmental. Dodgson et al, 2002
41
What diagram depicts the contextual, distal + proximal determinants of health and the globalisation process?
The conceptual framework by Huynen et al., 2005
42
What are the contextual determinants of health?
Institutional - global governance structures Economic - Global markets Social-cultural - global communication + diffusion of information global mobility; cross-cultural interaction Environmental - global environmental change
43
What are the distal determinants of health?
Institutional - health policy; health-related policy Economic - economic development, trade Social-cultural - Knowledge, social interactions Environmental - ecosystem goods + services
44
What are the proximal determinants of health?
Institutional - health services Social-cultural - social environment, lifestyle Environmental - food + water; physical environment
45
What is the double burden of disease?
NCDs are imposing a growing burden upon LMICs - limited resources + still struggling to meet challenges of existing problems with CDs (WHO) NCDs kill 38 million people each year Almost 3/4s of NCD deaths occur in LMICs 16million NCD deaths occur before age of 70; 82% LMICs
46
What are the implications of globalization for health?
Intensified transborder health risks Growth in number + influence of non state actors e.g. civil society, private companies Decline in the capacity of nation-states
47
What is the global health governance landscape increasingly adopting?
A contested, increasingly unstructured playing field but it is also a restricted one featuring new players with new power dynamics
48
What is the difference between global governance for health and national?
Borders are not present in global health terms - global public goods Governance is more fluid in global and has more actors with increased complexity Government used to be the central player but no longer the case as there is a myriad of actors
49
Why should health system performance be measured?
To ensure that it is of a good + sufficient quality To identify any areas that need improving To measure the effectiveness + value of any intervention
50
Name 4 frameworks + tools for health system evaluation
The Health System Function Approach (WHO's BB framework) SWOT analysis 'Control knobs' framework Logical Framework approach
51
What is the definition of primary care?
A clinical healthcare service that is frontline/first point of call e.g. GP, family doctor, community health worker
52
What are the key principles of primary care?
``` First-contact Continuity Coordinating - integrates care over different providers Comprehensive - wide range of services Accessible - few barriers of access ```
53
How does primary care achieve wider health-improving actions?
Addressing the wider social determinants of health Intersectoral action for health Equity + social justice - a right to health Community empowerment
54
What was the first declaration that defined primary healthcare and when?
Alma-Ata Declaration 1978 Defined primary healthcare as a right; community participation; wider determinants of health;intersectoral action; equity Doesn't JUST encompass primary care - a wider vision for health + well-being and includes a range of movements + agendas which are all interlinked + essential
55
What is the newest renewed global commitment to primary healthcare?
Global Conference on Primary Health Care in Kazakhstan, 2018
56
What did the Global Conference on PHC in Kazakhstan 2018 cover?
PHC as a way of managing healthcare costs Expand coverage of basic healthcare Address wider social determinants of health Person-centred + community-orientated care 'Whole of society' approach Equity + social justice
57
What is different between the Alma-Ata Declaration 1978 to the Global Conference on PHC in Kazakhstan 2018?
Better evidence and understanding of ways to improve health now Primary healthcare is central to many of those
58
Name a case study to be used to illustrate the effects of Primary Healthcare
Brazil, Family Health Strategy | Health Reform began in 1980s as weak PHC + over centralised system
59
Give a brief background of the history + economic background of Brazil
MIC 7th largest economy in the world 200 million people
60
What are the health challenges in Brazil?
Ageing population Poverty Obesity Inequality - slums in Rio
61
What were the main findings from the Family Health Strategy, Brazil?
ESF coverage greater in the lowest income groups - population that is most disadvantaged benefit most from primary healthcare
62
What are the challenges that face the Family Health Strategy, Brazil?
Uptake in urban areas still low Variable administrative capacity to manage local health services Challenges for access - lack of Drs in public system; availability of appointments; wait times
63
What are the issues with the overall evidence on primary care?
Mostly from HICs Variability in definitions Selective health outcomes considered Variation in exposure
64
What does the overall evidence on PHC show?
Reduction in mortality - children, CVD + resp illnesses Lower hospitalisations from ACSCs Lower costs Improved equity
65
What is the difference between primary care and primary healthcare?
Primary care = service | Primary healthcare = societal vision
66
What are the social determinants of health?
The conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power + resources at a global, national and local levels
67
What model illustrates the wider determinants of health?
Dahlgren and Whitehead, 1991 (rainbow)
68
What did Dahlgren and Whitehead's model show?
The wider determinants of health ``` Age, sex + constitutional factors Individual lifestyle factors Social + community networks Living and working conditions General socio-economic, cultural and environmental conditions ```

Global Health BSc 2018/19 - GHG (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions