Who definition of health systems
a. Sum of organizations, institutions, and resources whose primary purpose is to improve health
components of health systems
- Agencies that plan, fund and regulate health care
- The money that finances health care
- Those who provide preventive health services
- Those who provide clinical services
- Those who provide specialized inputs into health care,
such as the education of healthcare professionals and the
production of drugs and medical devices
goals of health systems
- Good health
- Responsive to society expectations
- Fairness of financial contribution
functions of health systems
- Provide health services
- Generate resources
- Financing = pay for health services
- Stewardship = govern and regulate health systems, partly government
US health system
all four, pluralistic
UK
beveridge model
germany
bismarck model, sickness found
canada
NHI model, partnership between government and private, like medicare
Out-of-pocket model
fee determined by market
levels of care
a. Primary
b. Secondary
c. Tertiary
primary health care
a. Essential and socially acceptable
b. Based on evidence and universally available
c. Addresses the needs of the community and is affordable
d. Provides preventive, promotive, curative, and rehabilitative services
e. Linked to health system through referral system
alma alta
- First articulated in Declaration of Alma-Ata
- Established health as a human right
- Primary health care is care that is essential and socially
- acceptable, based on evidence and made universally
available - Set the goal of “health for all” by 2000
- Important to identify as different than “primary care” –
meaning first level care
medicare
funded by SS tax, for 65+, insurance program
medicaid
assistance program, serves low-income people of every age
key health sector issues
a. Availability
1. Facilities, staff, supplies
b. Accessibility
2. Geographically and physically accessible
c. Affordability
1. Economically accessible
d. Acceptability
1. Respect for patient
e. Quality
1. Management, maintenance, skills
why is being born female more dangerous
a. Increased susceptibility to some infections
b. Cervicle, ovarian, breast
c. More susceptible to STI
why females are more physiologically susceptible to infections
a. Women have larger mucosal area more opened to the outside world
b. Men have larger amount of semen larger viral load
three delays
-delay in recognizing complications and seeking care
-delay in transport of mother to hospital
-delay in providing needed emergency obstetric care
physiological determinants of women’s health
- Increased susceptibility to some infections
- Cervicle, ovarian, breast
- More susceptible to STI
- Women have larger mucosal area more opened to the outside world
- Men have larger amount of semen larger viral load
social determinants of women’s health
- Gender norms and roles
- Female abortion or infanticide
- Fed less nutritious food
- Male dominance physical and sexual abuse
- Cooking with poor ventilation responsible for disease
- Low social status limits access to health care
sex-selective abortion
a. In a natural setting, there are more females born 100:105
b. Skewed ratio of male to female with sex-selective abortion
1. Chindi
2. India
3. Taiwan
4. Singapore
5. South korea
c. Education and income role
1. Can tell gender earlier more abortion
2. Doesn’t change attitude, still want son and only 2 kids
3. Wrong incentive
complications of unsafe abortion
a. Highest in middle Africa
b. Leading and preventable cause of maternal deaths and morbidities
c. Lack of access to safe, timely, affordable and respectful abortion care
which region has the highest rate of unsafe abortion
a. South africa
b. The US is high and not going down
c. Lowest = the netherlands
leading causes of maternal death globally
a. Indirect causes
b. Hemorrhage
c. Hypertensive disorders
