Week 2 Notes- Comparative Health Care Systems
Week 2 Notes- Comparative Health Care Systems PHP 1100
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This 5 page Class Notes was uploaded by Isabel Blalock on Thursday February 11, 2016. The Class Notes belongs to PHP 1100 at Brown University taught by Dr. Omar Galarraga in Winter 2016. Since its upload, it has received 126 views. For similar materials see Comparative Healthcare Systems in Public Health at Brown University.
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Date Created: 02/11/16
Week 2 02/12/2016 ▯ Lecture 3 ▯ February 9, 2016 ▯ ▯ Globalization and Health Systems ▯ ▯ Weak health systems ▯ Shortage of staff (particularly well-trained staff) ▯ Poorly motivated workforce (low pay, poor working conditions) ▯ Weal drug supply systems ▯ Lack of information for management ▯ Weak supervisory and accountability structures at all levels (from local clinic to Ministry of Health) ▯ ▯ Issues to consider ▯ Strong health systems are needed to achieve disease-specific control & treatment objectives ▯ Agencies want quick results ▯ “magic bullet” not available, nor appropriate to tackle complex web of issues to address in LMIC health systems ▯ no one way to solve issues ▯ ▯ Globalized world ▯ Highly integrated, globalized world need globalized solutions ▯ “diseases know no boundaries” ▯ Telecommunications; travel: ideas homogeneity expectations ▯ Internet makes information travel faster ▯ Homogeneity among the (young) middle class across countries ▯ Therefore, we make our expectations similar in terms of healthcare and access ▯ ▯ Globalized actions ▯ Reconsider concepts of local vs. foreign ▯ Is there still a foreign? ▯ Access to information means we know what is happening everywhere ▯ Transfer of risks: e.g., anti-tobacco laws in US markets elsewhere (targeting poorer people) ▯ Where cheap labor is and isn’t ▯ Where educated population is or isn’t ▯ Concept of “global public goods” ▯ Market will always take care of itself reallocation of resources ▯ global public goods are under-provided by the “free market” because they are: ▯ non-excludable: benefits of good available to all ▯ non-rival in consumption: consumption by one person does not prevent consumption by others (e.g. street lighting, clean air, etc) ▯ Examples of global health public goods—once it’s not there, we’re all safe ▯ HIV/AIDS treatment & prevention ▯ Tuberculosis (especially drug-resistant TB) ▯ Eradicable disease (e.g. polio) ▯ Anti-microbial resistant disease ▯ Diseases considered not to be GPGs: ▯ Malaria (regional public good) ▯ Transmitted by mosquito, can only travel so far ▯ Acute Respiratory Infection (poverty) ▯ Not contagious ▯ Diarrhea (analogous to ARI) ▯ Vaccine Preventable diseases (e.g. mumps) ▯ ▯ Interconnectedness ▯ E.g. aging in the West and brain drain from LMIC (nursing skills, etc. to meet demand) ▯ E.g. Marshall Plan—plan to rebuild Europe after the war vs. “waste of resources” ▯ How the US and allies saw investment and growth of global economy ▯ Trump- waste of money to invest in poor countries ▯ Mutually dependent processes ▯ ▯ Organization of USG Global Health Efforts ▯ The White House ▯ USAID ▯ State- PEPFAR ▯ HHS- CDC, NIH, FDA ▯ U.S. Global Health Funding has remained relatively flat since 2010 ▯ Other countries are more generous in their percentage of allocation ▯ Institute for Health Metrics and Evaluation—use for data analysis project ▯ Health financing tool ▯ Financing global health ▯ ▯ Disease risk pool emerging infectious disease outbreak epidemic pandemic ▯ High likelihood of occurrence annually? Or low? ▯ Low likelihood of severe health impact? Or high likelihood? ▯ ▯ Actions to build strong public health systems ▯ 1) revise public health law ▯ 2) strengthen public health infrastructure ▯ public health workforce ▯ surveillance and information systems ▯ laboratory capacity ▯ 3) build partnerships ▯ 4) use research evidence to inform decisions ▯ 5) engage and communicate with communities ▯ 6) establish a public health emergency operations center ▯ ex: 9/11, countries without reliable energy sources ▯ ▯ Need for specificity in health related targets in the sustainable development goals when, how ▯ ▯ Globalization and health systems ▯ Resources are necessary but not sufficient ▯ Health system infrastructure needs to be in place ▯ Long-run approach: maybe one to two generations long? (no “magic bullet”) ▯ Intervention Approaches ▯ Vertical ▯ “stove piping”- results for one disease, but other diseases are neglected ▯ conditionality: strings attached? ▯ PEPFAR must be devoted to HIV ▯ AIDS, TB, malaria + strengthening of health systems (must be constant) ▯ Horizontal ▯ diagonal ▯ ▯ Political framework ▯ Human rights international cooperation in matters of health ▯ “free rider problem” ▯ think that we’re benefiting from work of others ▯ if everyone else is pollution, why can’t I do it ▯ arguments based on future risk: invest now to avoid future large costs ▯ convincing people of importance of influenza pandemic; HIV as a national security threat) ▯ ▯ What is the common good at the global level? ▯ ▯ MDGs supposed to be over by 2015 but many countries didn’t achieve them ▯ Now we have SDGs due by 20125 ▯ ▯ ▯
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