The document analyzes alternatives for Haiti's government to provide HIV medication to its citizens. It discusses that Haiti currently has 120,000 people living with HIV but the government lacks resources to provide medication. The status quo alternative relies on NGOs like PSI to fund programs, but long-term stability is uncertain if NGOs withdraw support. A second alternative is passing an anti-discrimination law to reduce barriers patients face in accessing care. The document evaluates alternatives based on percentage of patients treated, cost-effectiveness, and feasibility of implementation in Haiti's unstable political environment.
The document summarizes findings from the 2008 Massachusetts Health Insurance Survey regarding access to healthcare among Massachusetts residents. Key findings include:
- Most residents had a usual source of care, doctor visits, and preventive care visits, though the uninsured and lower-income residents had lower rates of access.
- Over 20% of residents did not get needed care due to cost, with the uninsured and lower-income most affected.
- Difficulty accessing care and unmet needs were highest among the disabled, uninsured, and lower-income residents.
1) The World Health Organization (WHO) report "Health for the world's adolescents" addresses improving health outcomes for the world's one billion adolescents. It highlights both successes, such as declining adolescent pregnancy and maternal mortality rates in some regions, as well as ongoing challenges like HIV mortality among adolescents rising in Africa.
2) Adolescence is a crucial life stage for establishing health behaviors and patterns that affect future adult health. Many major causes of illness and death among adolescents, like road injuries, violence, and mental health issues, have preventable underlying factors.
3) Achieving overall health and development requires a holistic, multisector approach that addresses individual, social, and environmental determinants of adolescent health
Americans' Experience with the Health Care System in 2018Anne Marie Moran
The document summarizes key findings from an Ipsos study on Americans' health care experiences. Some of the main findings include:
- Americans are very concerned about health care costs, more so than other expenses like retirement or college. Premiums, deductibles, and co-pays are the top cost concerns.
- Over half of Americans say their out-of-pocket health care costs have increased in the past two years. Younger generations and those with private insurance see more cost increases.
- Americans mostly blame health insurance companies and pharmaceutical companies for rising out-of-pocket costs. The federal government is also seen as responsible by some.
- Overall quality of U.S. health care
Ghana faces a dual burden of both communicable and non-communicable diseases. While malaria and diarrhea remain problems, non-communicable diseases like hypertension, stroke and diabetes are increasingly common causes of death. Ghana's health system struggles to address this growing disease burden due to underfunding and understaffing of the National Health Insurance system. Policy changes are needed to improve sanitation, health education, and ensure universal access to healthcare through increased funding from taxes and the formal sector.
The percentage of persons in families having problems paying medical bills in the past 12 months decreased from 19.7% in 2011 to 14.2% in 2018 according to a National Health Interview Survey. In 2018, females, children aged 0-17, and non-Hispanic black persons were more likely than other groups to have problems paying medical bills. Among those under age 65, the uninsured had the highest rates of problems paying bills, followed by those with Medicaid or private insurance. For those over 65, those with Medicare and Medicaid or Medicare only had higher rates than those with Medicare Advantage or private coverage.
This document discusses syringe services programs (SSPs) and addresses common myths about them. It provides data showing that SSPs: 1) provide a variety of services beyond just syringe distribution, including medical care, testing, and referrals; 2) do not increase drug use or undermine safety, and may in fact reduce improperly discarded syringes and increase treatment enrollment; and 3) help reduce health disparities among injection drug users by increasing access to services. The document aims to dispel myths about SSPs and present evidence that they provide significant public health benefits.
Sustaining the HIV and AIDS Response in St. Vincent and the Grenadines: Inves...HFG Project
National surveillance reports estimate that there were about 649 persons living with HIV in St. Vincent and the Grenadines at the end of 2011, which translates to 1.2% of the adult population (15-49 years) or 0.7% of the total population. The epidemic is male-dominant, illustrated by the fact that the cumulative case reporting from 1984-2013 indicates that 60.6% of new cases are reported among males and 38.1% females (1.3% unknown). In response to the growing epidemic, the country quickly scaled up its national HIV/AIDS program in 2004. While care and treatment remains a high priority, St. Vincent and the Grenadines has devoted significant resources to preventative activities, including HIV counseling and rapid testing, education and workplace programs, and other behavioral interventions.
Despite a marked decline in HIV and AIDS cases, significant challenges for the country’s response remain. Close to 20% of persons with advanced HIV infection discontinue treatment within 12 months of initiation, suggesting the need to reinforce adherence and retention to care. The country also faces an imminent decline in donor funding and domestic reprioritization of chronic and non-communicable diseases; without renewed sources of external funding or greater domestic resources allocated to HIV/AIDS, progress made since 2004 could regress.
In response to these challenges, key priorities outlined in the country’s strategic framework (2014-2025) include: 1) institutionalizing HIV education through collaborative programs with different sectors, 2) targeting high risk groups, 3) strengthening HIV testing and counseling, including routine testing for pregnant women and, 4) ensuring access and retention to care and treatment for those with HIV and AIDS and TB. St. Vincent and the Grenadines has also taken steps to integrate HIV and AIDS services into the broader health system and included the HIV and AIDS program as part of the Ministry of Health, Environment and Wellness’ overall health framework. These actions are the beginning of efforts to improve access to care, reduce costs, and improve efficiencies.
Attitude of the youth towards voluntary counselling and testing (vct) of hiv ...Alexander Decker
This document summarizes a study on the attitudes of youth in Accra, Ghana toward voluntary counseling and testing (VCT) for HIV/AIDS. The study found that while knowledge of HIV/AIDS was high, awareness and use of VCT services was low. Most respondents were unaware that VCT services existed or where they could access them. Of those aware of VCT, very few had utilized the services themselves. Fear of knowing their HIV status appeared to be a major barrier preventing youth from seeking VCT. The study concluded that efforts must be made to increase awareness and use of VCT, especially among youth, through expanded information and education campaigns.
The document summarizes findings from the 2008 Massachusetts Health Insurance Survey regarding access to healthcare among Massachusetts residents. Key findings include:
- Most residents had a usual source of care, doctor visits, and preventive care visits, though the uninsured and lower-income residents had lower rates of access.
- Over 20% of residents did not get needed care due to cost, with the uninsured and lower-income most affected.
- Difficulty accessing care and unmet needs were highest among the disabled, uninsured, and lower-income residents.
1) The World Health Organization (WHO) report "Health for the world's adolescents" addresses improving health outcomes for the world's one billion adolescents. It highlights both successes, such as declining adolescent pregnancy and maternal mortality rates in some regions, as well as ongoing challenges like HIV mortality among adolescents rising in Africa.
2) Adolescence is a crucial life stage for establishing health behaviors and patterns that affect future adult health. Many major causes of illness and death among adolescents, like road injuries, violence, and mental health issues, have preventable underlying factors.
3) Achieving overall health and development requires a holistic, multisector approach that addresses individual, social, and environmental determinants of adolescent health
Americans' Experience with the Health Care System in 2018Anne Marie Moran
The document summarizes key findings from an Ipsos study on Americans' health care experiences. Some of the main findings include:
- Americans are very concerned about health care costs, more so than other expenses like retirement or college. Premiums, deductibles, and co-pays are the top cost concerns.
- Over half of Americans say their out-of-pocket health care costs have increased in the past two years. Younger generations and those with private insurance see more cost increases.
- Americans mostly blame health insurance companies and pharmaceutical companies for rising out-of-pocket costs. The federal government is also seen as responsible by some.
- Overall quality of U.S. health care
Ghana faces a dual burden of both communicable and non-communicable diseases. While malaria and diarrhea remain problems, non-communicable diseases like hypertension, stroke and diabetes are increasingly common causes of death. Ghana's health system struggles to address this growing disease burden due to underfunding and understaffing of the National Health Insurance system. Policy changes are needed to improve sanitation, health education, and ensure universal access to healthcare through increased funding from taxes and the formal sector.
The percentage of persons in families having problems paying medical bills in the past 12 months decreased from 19.7% in 2011 to 14.2% in 2018 according to a National Health Interview Survey. In 2018, females, children aged 0-17, and non-Hispanic black persons were more likely than other groups to have problems paying medical bills. Among those under age 65, the uninsured had the highest rates of problems paying bills, followed by those with Medicaid or private insurance. For those over 65, those with Medicare and Medicaid or Medicare only had higher rates than those with Medicare Advantage or private coverage.
This document discusses syringe services programs (SSPs) and addresses common myths about them. It provides data showing that SSPs: 1) provide a variety of services beyond just syringe distribution, including medical care, testing, and referrals; 2) do not increase drug use or undermine safety, and may in fact reduce improperly discarded syringes and increase treatment enrollment; and 3) help reduce health disparities among injection drug users by increasing access to services. The document aims to dispel myths about SSPs and present evidence that they provide significant public health benefits.
Sustaining the HIV and AIDS Response in St. Vincent and the Grenadines: Inves...HFG Project
National surveillance reports estimate that there were about 649 persons living with HIV in St. Vincent and the Grenadines at the end of 2011, which translates to 1.2% of the adult population (15-49 years) or 0.7% of the total population. The epidemic is male-dominant, illustrated by the fact that the cumulative case reporting from 1984-2013 indicates that 60.6% of new cases are reported among males and 38.1% females (1.3% unknown). In response to the growing epidemic, the country quickly scaled up its national HIV/AIDS program in 2004. While care and treatment remains a high priority, St. Vincent and the Grenadines has devoted significant resources to preventative activities, including HIV counseling and rapid testing, education and workplace programs, and other behavioral interventions.
Despite a marked decline in HIV and AIDS cases, significant challenges for the country’s response remain. Close to 20% of persons with advanced HIV infection discontinue treatment within 12 months of initiation, suggesting the need to reinforce adherence and retention to care. The country also faces an imminent decline in donor funding and domestic reprioritization of chronic and non-communicable diseases; without renewed sources of external funding or greater domestic resources allocated to HIV/AIDS, progress made since 2004 could regress.
In response to these challenges, key priorities outlined in the country’s strategic framework (2014-2025) include: 1) institutionalizing HIV education through collaborative programs with different sectors, 2) targeting high risk groups, 3) strengthening HIV testing and counseling, including routine testing for pregnant women and, 4) ensuring access and retention to care and treatment for those with HIV and AIDS and TB. St. Vincent and the Grenadines has also taken steps to integrate HIV and AIDS services into the broader health system and included the HIV and AIDS program as part of the Ministry of Health, Environment and Wellness’ overall health framework. These actions are the beginning of efforts to improve access to care, reduce costs, and improve efficiencies.
Attitude of the youth towards voluntary counselling and testing (vct) of hiv ...Alexander Decker
This document summarizes a study on the attitudes of youth in Accra, Ghana toward voluntary counseling and testing (VCT) for HIV/AIDS. The study found that while knowledge of HIV/AIDS was high, awareness and use of VCT services was low. Most respondents were unaware that VCT services existed or where they could access them. Of those aware of VCT, very few had utilized the services themselves. Fear of knowing their HIV status appeared to be a major barrier preventing youth from seeking VCT. The study concluded that efforts must be made to increase awareness and use of VCT, especially among youth, through expanded information and education campaigns.
Research done while in PwC Mexico. A short version was included as part of a PwC publication "Future of Pacific Alliance", that was presented at the presidental summit in Chile on July 2016.
The National HIV Prevention Inventory provides the first, comprehensive inventory of HIV prevention efforts at the state and local levels in the United States. Based on a survey of 65 health departments, including all state and territorial jurisdictions and six U.S. cities, the Inventory is intended to offer a baseline picture of how HIV prevention is delivered across the country in an effort to provide policymakers, public health officials, community organizations, and others with a more in depth understanding of HIV prevention and the role played by health departments in its delivery.
Noncommunicable diseases (NCDs) account for 71% of the deaths worldwideΔρ. Γιώργος K. Κασάπης
NCDs are not selective; they affect men and women in all countries and all socioeconomic classes, albeit with notable regional differences that influence intervention strategies and outcomes. Further amplifying the crisis, the high prevalence and chronic nature of NCDs have a direct impact on economies; the total global burden estimated to reach US$47 trillion between 2010 and 2030. Upjohn, a Pfizer division, shares insights on the major causes, trends and methods of intervention against NCDs.
The value of health to an economy is hard to quantify, but its importance is undeniable. A population’s health plays a key role in economic progress, and in coming years healthcare will be a key area of focus for policymakers, payers,providers and the public alike. Financing the future: Choices and challenges in global health studies the role of healthcare against a backdrop of changing demographic patterns, rising healthcare costs and technological innovation.
Healthcare oligopoly is Affecting u.s. economy convertedRoyJMeidinger
The document provides an overview of rising healthcare costs and declining outcomes in the United States compared to other developed nations. It notes that while the US spends much more per capita on healthcare, it has lower life expectancy and rates of preventable deaths than peers. The high costs are driven by administrative waste, high prices, and lack of cost control. The document argues that healthcare costs are a major burden on the US economy and individuals, and that reforms are needed to reduce costs while improving access and outcomes for all Americans.
This world health report discusses universal health coverage and how to achieve it. It notes that while access to health services is critical, many people still lack coverage and face financial hardship. It identifies three main barriers to universal coverage: insufficient resources, overreliance on direct payments, and inefficient resource use. The report argues that countries need to raise sufficient funds, reduce direct payments, and improve efficiency to make progress toward universal coverage. It provides options for actions that all countries can consider.
The document is a global policy report on viral hepatitis prevention and control by the World Health Organization. It finds that viral hepatitis is a widespread and growing disease burden globally that causes liver damage and cancer. While tools exist to prevent and treat hepatitis, more action is needed as many infections are asymptomatic until serious liver damage occurs. The report analyzes data from a WHO survey of member states on their hepatitis policies and programs. It identifies gaps in prevention, screening, and treatment efforts and areas where WHO can provide assistance to member states in developing more effective national and localized response strategies.
1) SSPs prevent the spread of HIV and hepatitis C by providing clean syringes and linking drug users to medical services, saving millions in treatment costs.
2) They serve as bridges to drug treatment programs and have been shown to increase employment and access to healthcare.
3) However, the current federal ban on funding undermines local public health efforts and prevents communities from using evidence-based approaches tailored to local needs.
Summary Findings of an Opinion Research Survey On Health Reform LegislationeHealth , Inc.
eHealth, Inc. commissioned this nationwide survey to better understand consumer behavior and expectations in the context of current health insurance reform legislation. This report summarizes findings of a telephone survey conducted among a random national sample of 1,003 adults 18 years of age and older, living in private households in the continental United States. Interviewing for this survey was completed by Opinion Research Corporation during the period December 4 - 7, 2009. See the Methodology section of this report for additional information about the margin of error for this study and its applicability to the surveyed sample of adults.
Haiti has the highest rates of child, neonatal, and maternal mortality in the Western Hemisphere. In 2013, Haiti's neonatal mortality rate was 25 per 1000 live births, infant mortality rate was 55 per 1000 live births, and child mortality rate for those under 5 was 73 per 1000. The maternal mortality ratio in Haiti was 380 per 100,000 live births in 2013. The authors identify poverty, preterm birth, low birth weight, lack of access to care for pneumonia and antibiotics, and complications during childbirth as key contributing factors to these high mortality rates in Haiti. They propose establishing a network of community care and a central referral hospital to improve access to evidence-based interventions and reduce mortality rates.
Presentation Fam Med Masters Seminar Apr 25 07briefJanet2007
The document discusses the impact of poverty on health. It provides background on poverty and health indicators in Canada, showing that those in poverty experience higher rates of chronic disease, infant mortality, lower life expectancy, and worse mental and physical health overall. It suggests that poverty, through factors like inadequate income for nutrition and housing, is the main determinant of these health inequities. The document proposes ways for health providers to help address poverty, such as by expanding assessments of social/economic barriers patients face and connecting them to resources to improve their situations.
The next pandemic? Non-communicable diseases in developing countries is an Economist Intelligence Unit report. It examines the growing burden of non-communicable diseases (NCDs) in low- and lower-middle-income countries, the drivers of this change, and possible solutions for how healthcare systems can bridge the resource gap to deliver appropriate NCD care for patients. The findings of this report are based on data analysis, desk research and five in-depth interviews with senior healthcare experts.
This document summarizes findings from tracking development assistance for health (DAH) globally. It discusses methods for estimating DAH from 1990-2010, key findings on trends in DAH and recipient government responses. It also outlines uncertainties in future global health financing due to economic conditions and priorities among donors. DAH has increased dramatically for HIV/AIDS, malaria and tuberculosis but less for maternal and child health and non-communicable diseases. On average, recipient governments decrease health spending by 43 cents to $1.14 for every dollar of DAH received. The outcome on future global health financing depends on donor priorities during fiscal contraction periods.
This document discusses poverty and health inequities. It finds that those living in poverty experience significantly higher rates of many health issues compared to more affluent groups. For example, in Saskatoon low-income residents are over 1000% more likely to be hospitalized for diabetes or have chlamydia. A survey found most people agree the poor have worse health, and support policies to strengthen early childhood programs, increase income supplements, and expand disease prevention. The document calls on governments and communities, including faith groups, to work together using evidence-based solutions to improve conditions for daily living and reduce health inequities over time.
Between 2013 and 2015:
- Uninsured rates for adults declined in all states, by at least 3 percentage points in 48 states. States that expanded Medicaid eligibility saw the largest declines of 10-13 percentage points.
- Uninsured rates among low-income adults also declined in every state. States that expanded Medicaid generally had lower uninsured rates among low-income adults.
- The share of children who were uninsured dropped by at least 2 percentage points in 28 states.
While access to coverage increased significantly nationwide due to the Affordable Care Act, some states still had high uninsured rates, especially for low-income populations. States that expanded Medicaid eligibility achieved greater reductions in uninsured individuals.
This document discusses the potential for social protection approaches to address social determinants of tuberculosis (TB) by drawing on lessons from HIV-sensitive social protection. It summarizes that social protection exists on a spectrum from transformative to protective approaches. Experience from HIV shows that social protection can influence health outcomes through multiple entry points across the prevention and treatment continuum. Specifically, conditional cash transfers have been shown to reduce poverty and inequality, increase uptake of voluntary counseling and testing, and reduce sexually transmitted infections when tied to remaining infection-free. However, directly tying incentives to HIV status has not yet demonstrated impact. Social protection can also facilitate HIV treatment access directly through interventions like transportation assistance and indirectly by reducing stigma.
Sustaining the HIV and AIDS Response in the Countries of the OECS: Regional I...HFG Project
In 2014, the six countries of the Organization of Eastern Caribbean States (OECS) of Antigua and Barbuda, Dominica, Grenada, St. Kitts and Nevis, St. Lucia and St. Vincent and the Grenadines developed HIV and AIDS Investment Case Briefs, with the support of USAID’s Health Finance and Governance (HFG) and Strengthening Health Outcomes through the Private Sector (SHOPS) projects. This document provides a summary of the findings of these briefs, which includes an analysis of the costs of HIV and AIDS programs that respond to the disease in the six countries, the resources that are available, the funding gaps, and the potential impact of different levels of investment in programming on the progression of the disease in the region.
Health care disparities exist between different racial and ethnic groups in the United States. The WHO defines health disparities as differences in health outcomes that are closely linked to social and economic disadvantage. There can be up to a 33 year difference in life expectancy between racial groups. Disparities are driven by social determinants like education, income, and environment. Minority groups face greater barriers to accessing quality health care due to lack of insurance, language barriers, and provider biases. Addressing disparities requires improvements in data collection, the health workforce, and policies aimed at promoting equity.
Running head PUBLIC HEALTH INITIATIVE2Publi.docxtodd581
Running head: PUBLIC HEALTH INITIATIVE 2
Public Health Initiative
Abraham Anderson
Walden University
Principles of economics for evaluating and assessing the need for the public health initiative
Public Health is a science that all in all expects to improve and lessen disparities in wellbeing. Public Health economics manages the basic leadership process for public health professionals in the usage of accessible resources while limiting opportunity cost (Edwards, Charles and Lloyd-Williams, 2013). The initiative will concentrate on making HIV testing a routine that will assist in decreasing and HIV. HIV represents human immunodeficiency virus. It debilitates an individual's immune system by crushing vital cells that battle infection and disease. The ascent in HIV is an expanding worry to public health making the need for consideration to decrease the potential health impacts it has on the human population. HIV is running fast in the population because of low salary, poor or no medicinal services, flooding rates of sexually transmitted infection's and people who have no idea of their HIV status.
A brief description of whether the initiative is a micro or macroeconomic program
The public health initiative to help lessen and counteract HIV is a macroeconomic program. The HIV issue is not just an individual concern yet additionally influences the country in general. When individuals are HIV, they are prone to various medical conditions like pneumonia, tuberculosis (TB), and other respiratory infections; lymphoma, cervical cancer, and other cancers; cardiovascular disease; and problems that affect the brain and central nervous system such as dementia, nerve damage, and memory problems, which have the potential of influencing the productivity of such people (Iribarren et al., 2018). At the point when a critical number of people are not productive because of HIV and these conditions, it turns into a risk to a nation's monetary development on the grounds that the country development is reliant on the profitability of its natives. At the end of 2015, an estimated 1.1 million persons aged 13 and older were living with HIV infection in the United States, including an estimated 162,500 (15%) persons whose infections had not been diagnosed. A ton of assets allotment is towards guaranteeing healthcare administrations are accessible to people in general to get to treatment for HIV and conditions that are appended to them.
A determination of whether the result of the initiative is a public or private good
The public health initiative in diminishing HIV is a public good. In economics, public goods are those which its utilization by one individual does not decrease the sum accessible for others to expend and are comprehensive to such an extent that nobody is barred from getting a charge out of the advantages related with them (Grossman, Pierskalla, & Dean, 2017). Public health initiatives are an element of different components both b.
Healthcare Explain the implications for healthcare based on the geographic.pdfsdfghj21
1) Population trends like an aging population and increasing chronic diseases will increase demands on the healthcare system and costs. Treating seniors and managing chronic conditions requires more resources.
2) Geographic disparities exist in disease prevalence across US regions. For example, Southern states have higher rates of HIV/AIDS than other areas. Treating concentrated health issues in certain locations also impacts resource needs.
3) Psychographic trends like increasing sedentary lifestyles are linked to higher risks of obesity, diabetes, and other chronic conditions, raising healthcare costs to treat and manage these issues. Meeting new demands from population changes requires planning healthcare delivery and financing.
Research done while in PwC Mexico. A short version was included as part of a PwC publication "Future of Pacific Alliance", that was presented at the presidental summit in Chile on July 2016.
The National HIV Prevention Inventory provides the first, comprehensive inventory of HIV prevention efforts at the state and local levels in the United States. Based on a survey of 65 health departments, including all state and territorial jurisdictions and six U.S. cities, the Inventory is intended to offer a baseline picture of how HIV prevention is delivered across the country in an effort to provide policymakers, public health officials, community organizations, and others with a more in depth understanding of HIV prevention and the role played by health departments in its delivery.
Noncommunicable diseases (NCDs) account for 71% of the deaths worldwideΔρ. Γιώργος K. Κασάπης
NCDs are not selective; they affect men and women in all countries and all socioeconomic classes, albeit with notable regional differences that influence intervention strategies and outcomes. Further amplifying the crisis, the high prevalence and chronic nature of NCDs have a direct impact on economies; the total global burden estimated to reach US$47 trillion between 2010 and 2030. Upjohn, a Pfizer division, shares insights on the major causes, trends and methods of intervention against NCDs.
The value of health to an economy is hard to quantify, but its importance is undeniable. A population’s health plays a key role in economic progress, and in coming years healthcare will be a key area of focus for policymakers, payers,providers and the public alike. Financing the future: Choices and challenges in global health studies the role of healthcare against a backdrop of changing demographic patterns, rising healthcare costs and technological innovation.
Healthcare oligopoly is Affecting u.s. economy convertedRoyJMeidinger
The document provides an overview of rising healthcare costs and declining outcomes in the United States compared to other developed nations. It notes that while the US spends much more per capita on healthcare, it has lower life expectancy and rates of preventable deaths than peers. The high costs are driven by administrative waste, high prices, and lack of cost control. The document argues that healthcare costs are a major burden on the US economy and individuals, and that reforms are needed to reduce costs while improving access and outcomes for all Americans.
This world health report discusses universal health coverage and how to achieve it. It notes that while access to health services is critical, many people still lack coverage and face financial hardship. It identifies three main barriers to universal coverage: insufficient resources, overreliance on direct payments, and inefficient resource use. The report argues that countries need to raise sufficient funds, reduce direct payments, and improve efficiency to make progress toward universal coverage. It provides options for actions that all countries can consider.
The document is a global policy report on viral hepatitis prevention and control by the World Health Organization. It finds that viral hepatitis is a widespread and growing disease burden globally that causes liver damage and cancer. While tools exist to prevent and treat hepatitis, more action is needed as many infections are asymptomatic until serious liver damage occurs. The report analyzes data from a WHO survey of member states on their hepatitis policies and programs. It identifies gaps in prevention, screening, and treatment efforts and areas where WHO can provide assistance to member states in developing more effective national and localized response strategies.
1) SSPs prevent the spread of HIV and hepatitis C by providing clean syringes and linking drug users to medical services, saving millions in treatment costs.
2) They serve as bridges to drug treatment programs and have been shown to increase employment and access to healthcare.
3) However, the current federal ban on funding undermines local public health efforts and prevents communities from using evidence-based approaches tailored to local needs.
Summary Findings of an Opinion Research Survey On Health Reform LegislationeHealth , Inc.
eHealth, Inc. commissioned this nationwide survey to better understand consumer behavior and expectations in the context of current health insurance reform legislation. This report summarizes findings of a telephone survey conducted among a random national sample of 1,003 adults 18 years of age and older, living in private households in the continental United States. Interviewing for this survey was completed by Opinion Research Corporation during the period December 4 - 7, 2009. See the Methodology section of this report for additional information about the margin of error for this study and its applicability to the surveyed sample of adults.
Haiti has the highest rates of child, neonatal, and maternal mortality in the Western Hemisphere. In 2013, Haiti's neonatal mortality rate was 25 per 1000 live births, infant mortality rate was 55 per 1000 live births, and child mortality rate for those under 5 was 73 per 1000. The maternal mortality ratio in Haiti was 380 per 100,000 live births in 2013. The authors identify poverty, preterm birth, low birth weight, lack of access to care for pneumonia and antibiotics, and complications during childbirth as key contributing factors to these high mortality rates in Haiti. They propose establishing a network of community care and a central referral hospital to improve access to evidence-based interventions and reduce mortality rates.
Presentation Fam Med Masters Seminar Apr 25 07briefJanet2007
The document discusses the impact of poverty on health. It provides background on poverty and health indicators in Canada, showing that those in poverty experience higher rates of chronic disease, infant mortality, lower life expectancy, and worse mental and physical health overall. It suggests that poverty, through factors like inadequate income for nutrition and housing, is the main determinant of these health inequities. The document proposes ways for health providers to help address poverty, such as by expanding assessments of social/economic barriers patients face and connecting them to resources to improve their situations.
The next pandemic? Non-communicable diseases in developing countries is an Economist Intelligence Unit report. It examines the growing burden of non-communicable diseases (NCDs) in low- and lower-middle-income countries, the drivers of this change, and possible solutions for how healthcare systems can bridge the resource gap to deliver appropriate NCD care for patients. The findings of this report are based on data analysis, desk research and five in-depth interviews with senior healthcare experts.
This document summarizes findings from tracking development assistance for health (DAH) globally. It discusses methods for estimating DAH from 1990-2010, key findings on trends in DAH and recipient government responses. It also outlines uncertainties in future global health financing due to economic conditions and priorities among donors. DAH has increased dramatically for HIV/AIDS, malaria and tuberculosis but less for maternal and child health and non-communicable diseases. On average, recipient governments decrease health spending by 43 cents to $1.14 for every dollar of DAH received. The outcome on future global health financing depends on donor priorities during fiscal contraction periods.
This document discusses poverty and health inequities. It finds that those living in poverty experience significantly higher rates of many health issues compared to more affluent groups. For example, in Saskatoon low-income residents are over 1000% more likely to be hospitalized for diabetes or have chlamydia. A survey found most people agree the poor have worse health, and support policies to strengthen early childhood programs, increase income supplements, and expand disease prevention. The document calls on governments and communities, including faith groups, to work together using evidence-based solutions to improve conditions for daily living and reduce health inequities over time.
Between 2013 and 2015:
- Uninsured rates for adults declined in all states, by at least 3 percentage points in 48 states. States that expanded Medicaid eligibility saw the largest declines of 10-13 percentage points.
- Uninsured rates among low-income adults also declined in every state. States that expanded Medicaid generally had lower uninsured rates among low-income adults.
- The share of children who were uninsured dropped by at least 2 percentage points in 28 states.
While access to coverage increased significantly nationwide due to the Affordable Care Act, some states still had high uninsured rates, especially for low-income populations. States that expanded Medicaid eligibility achieved greater reductions in uninsured individuals.
This document discusses the potential for social protection approaches to address social determinants of tuberculosis (TB) by drawing on lessons from HIV-sensitive social protection. It summarizes that social protection exists on a spectrum from transformative to protective approaches. Experience from HIV shows that social protection can influence health outcomes through multiple entry points across the prevention and treatment continuum. Specifically, conditional cash transfers have been shown to reduce poverty and inequality, increase uptake of voluntary counseling and testing, and reduce sexually transmitted infections when tied to remaining infection-free. However, directly tying incentives to HIV status has not yet demonstrated impact. Social protection can also facilitate HIV treatment access directly through interventions like transportation assistance and indirectly by reducing stigma.
Sustaining the HIV and AIDS Response in the Countries of the OECS: Regional I...HFG Project
In 2014, the six countries of the Organization of Eastern Caribbean States (OECS) of Antigua and Barbuda, Dominica, Grenada, St. Kitts and Nevis, St. Lucia and St. Vincent and the Grenadines developed HIV and AIDS Investment Case Briefs, with the support of USAID’s Health Finance and Governance (HFG) and Strengthening Health Outcomes through the Private Sector (SHOPS) projects. This document provides a summary of the findings of these briefs, which includes an analysis of the costs of HIV and AIDS programs that respond to the disease in the six countries, the resources that are available, the funding gaps, and the potential impact of different levels of investment in programming on the progression of the disease in the region.
Health care disparities exist between different racial and ethnic groups in the United States. The WHO defines health disparities as differences in health outcomes that are closely linked to social and economic disadvantage. There can be up to a 33 year difference in life expectancy between racial groups. Disparities are driven by social determinants like education, income, and environment. Minority groups face greater barriers to accessing quality health care due to lack of insurance, language barriers, and provider biases. Addressing disparities requires improvements in data collection, the health workforce, and policies aimed at promoting equity.
Running head PUBLIC HEALTH INITIATIVE2Publi.docxtodd581
Running head: PUBLIC HEALTH INITIATIVE 2
Public Health Initiative
Abraham Anderson
Walden University
Principles of economics for evaluating and assessing the need for the public health initiative
Public Health is a science that all in all expects to improve and lessen disparities in wellbeing. Public Health economics manages the basic leadership process for public health professionals in the usage of accessible resources while limiting opportunity cost (Edwards, Charles and Lloyd-Williams, 2013). The initiative will concentrate on making HIV testing a routine that will assist in decreasing and HIV. HIV represents human immunodeficiency virus. It debilitates an individual's immune system by crushing vital cells that battle infection and disease. The ascent in HIV is an expanding worry to public health making the need for consideration to decrease the potential health impacts it has on the human population. HIV is running fast in the population because of low salary, poor or no medicinal services, flooding rates of sexually transmitted infection's and people who have no idea of their HIV status.
A brief description of whether the initiative is a micro or macroeconomic program
The public health initiative to help lessen and counteract HIV is a macroeconomic program. The HIV issue is not just an individual concern yet additionally influences the country in general. When individuals are HIV, they are prone to various medical conditions like pneumonia, tuberculosis (TB), and other respiratory infections; lymphoma, cervical cancer, and other cancers; cardiovascular disease; and problems that affect the brain and central nervous system such as dementia, nerve damage, and memory problems, which have the potential of influencing the productivity of such people (Iribarren et al., 2018). At the point when a critical number of people are not productive because of HIV and these conditions, it turns into a risk to a nation's monetary development on the grounds that the country development is reliant on the profitability of its natives. At the end of 2015, an estimated 1.1 million persons aged 13 and older were living with HIV infection in the United States, including an estimated 162,500 (15%) persons whose infections had not been diagnosed. A ton of assets allotment is towards guaranteeing healthcare administrations are accessible to people in general to get to treatment for HIV and conditions that are appended to them.
A determination of whether the result of the initiative is a public or private good
The public health initiative in diminishing HIV is a public good. In economics, public goods are those which its utilization by one individual does not decrease the sum accessible for others to expend and are comprehensive to such an extent that nobody is barred from getting a charge out of the advantages related with them (Grossman, Pierskalla, & Dean, 2017). Public health initiatives are an element of different components both b.
Healthcare Explain the implications for healthcare based on the geographic.pdfsdfghj21
1) Population trends like an aging population and increasing chronic diseases will increase demands on the healthcare system and costs. Treating seniors and managing chronic conditions requires more resources.
2) Geographic disparities exist in disease prevalence across US regions. For example, Southern states have higher rates of HIV/AIDS than other areas. Treating concentrated health issues in certain locations also impacts resource needs.
3) Psychographic trends like increasing sedentary lifestyles are linked to higher risks of obesity, diabetes, and other chronic conditions, raising healthcare costs to treat and manage these issues. Meeting new demands from population changes requires planning healthcare delivery and financing.
This document summarizes a report analyzing Medicaid expansion in Florida and Georgia as a policy tool to address health disparities. The report was prepared by students in a domestic health policy workshop. It finds that expanding Medicaid in Florida could reduce health disparities by increasing access to preventative care for uninsured Floridians and minorities. Three options for Medicaid expansion are examined: standard expansion and two alternative models from Michigan and Tennessee. The analysis concludes that Medicaid expansion would likely improve health outcomes in Florida while saving costs compared to the status quo.
When responding to your peers, provide your own evaluation of the povictorring
When responding to your peers, provide your own evaluation of the policies discussed in their posts. Respectfully agree or disagree with your peers’ evaluations. What suggestions for improving the policies can you add? What suggestions provided by your peers do you see as the most valuable?
Discussion:
President John F. Kennedy once stated “children are the world’s most valuable resource and its best hope for the future” (JFK Library, N.D.). Children are very important to our society and our world, and an important vulnerable population to discuss. A healthcare concern both nationally and globally for children is HIV.
In 2018, there were over 37,000 new cases of HIV diagnosed in the United States, and 21% of those cases were youth aged thirteen to twenty-four (CDC, 2020). In comparison to adults with HIV, youth have the lowest rates of viral suppression and less than half received care related to HIV (CDC, 2020). Transmission for children and youth occurs from different sources including unprotected sexual contact, perinatal exposure, injectable drug use and transmission through hemophilia and blood transfusion treatments (CDC, 2020). One hundred and forty nine deaths of young people were due to HIV in 2017 (CDC, 2020).
There are still many challenges related to prevention and education for children and youth related to HIV. Health-related behaviors such as underage drinking and substance use and low rates of condom use, lead to youth engaging in unprotected sex when under the influence of alcohol and drugs (CDC, 2020). There are socioeconomic factors as well for children and youth with HIV, as teenagers infected are more likely than older adults to live in households with lower income levels and less access to healthcare (CDC, 2020). Lower rates of pre-exposure prophylaxis and testing occur with children and youth due to cost, access and continued stigma and misperceptions regarding HIV (CDC, 2020).
The Ryan White HIV/AIDS Program was developed in 1990 and is administered by the U.S. Department of Health and Human Services, Health Resources and Services Administration and the HIV/AIDs Bureau (HRSA, 2019). The program assists in providing comprehensive HIV medical care, prescriptions for low-income people, and provides support services, as well as, provides funding for grants to states and local community based public health centers to provide increased health outcomes and assist in reducing the risk of transmission of HIV (HRSA, 2019). More than half of children diagnosed with HIV in the United States receive services through the Ryan White program annually (HRSA, 2019).
The passing of the Affordable Care Act in 2010 assisted parents of children with pre-existing conditions, including HIV, from being denied insurance coverage (CDC, 2020). Another benefit to the Affordable Care Act is that insurance companies cannot have lifetime caps on insurance benefits which allows child ...
Running head VULNARABE POPULATION 1VULNARABLE POPULATION .docxjenkinsmandie
Running head: VULNARABE POPULATION 1
VULNARABLE POPULATION 7
People diagnosed with HIV/AIDS
Student
Tutor
Course
Date
HIV/AIDS is one of the many factors that are usually affecting the world. Research shows that a total number of 1.1 million people are living with HIV, and 75% of the population in amerce don’t know that they get infected with the virus (Burkholder & Nash, Special populations in health care, 2013). HIV/AIDS affects people from all genders, races, and ethnic age. Today the most significant population of people living with HIV/AIDS are more affected in terms of Medicare and Medicaid. Healthcare facility though they offer antiretroviral which helps prolong patients with HIV it’s not sufficient enough to a permanent solution.
HIV/AIDS is more severe among the young generation. The youth are more likely to get HIV/AIDS than the old due to so many activities to which they indulge. When it comes to age HIV/AIDs, the young are more like to survive longer if they engage early with the treatment procedure and healthier factor than the old. When the old generation gets infected with HIV/AIDS that creates a crisis in the next generation in terms of survival, those affected are more likely to lose jobs, education, and health care to discrimination and end up relying on aid. The reliance on welfare is more likely to happen among those with HIV/AIDS as well to help mitigate their health condition.
According to research, those populations with HIV/AIDS are more likely to spend most of their incomes on healthcare than other items. HIV/AIDS populations are more like not to get hired on a job due to health issues and risk poverty lines. When a country has a large population of people with HIV/AIDS the country is headed in crisis and is likely to lead under a financial crisis to healthcare management. Infrastructure development and other beneficial programs that might benefit the country are halted to stop epidemic rise of HIV/AIDS in the country. There are no special jobs designed for those with HIV/AIDS, thus forcing the broad population into poverty. To mitigate the income crisis the government and private parties should work together and find way to help create specific jobs and cheap healthcare programs.
Analyze the intersection of social, political, and economic factors affecting vulnerability (must address all three factors)
Social factors that affect the population with HIV/AIDS. Communities with a higher living among poverty line is more affected with HIV/AIDS than those community among the wealthy status. Those based on the poverty line spend the little they have in healthcare; the more the population is affected by healthcare problems, the likelier infrastructure and development get halted. Those, however, living in wealthy communities they have enough money to pay for healthcare and support infrastructure and other development as well. Social factor have a significant role in how they treat and mitigate the spread of .
Florida faces significant health disparities, with minority populations experiencing higher rates of diseases like HIV/AIDS, cervical cancer, and gonorrhea. Uninsurance contributes to these disparities through lack of access to preventative care and treatment. Expanding Medicaid would provide coverage to around 877,000 Floridians and address the disparities. It would improve health outcomes and reduce costs by increasing access to care, lowering uncompensated costs for hospitals by $1.3 billion annually. While expansion faces political opposition, it has majority public support and would benefit both the population and state economy through increased jobs and revenue of over $8 billion.
Fragmentation of health care delivery services in africaAlexander Decker
This document summarizes issues with how donor funding for healthcare projects in Africa has fragmented services and undermined public health systems. Donors often fund narrow vertical projects focused on diseases that interest Western audiences, like HIV/AIDS, rather than building sustainable national systems. This leads to a lack of coordination, duplication of efforts, and depletion of local healthcare workers who leave for better paying jobs with NGOs implementing donor projects. While donor funding has helped control some diseases, it has not improved overall health outcomes in Africa and has weakened public health infrastructure by not prioritizing capacity building and local ownership over targeting specific diseases.
This study examined the association between socioeconomic status and willingness to pay (WTP) for medical care among government school teachers in Addis Ababa, Ethiopia. A survey was administered to 847 teachers to assess their WTP for three hypothetical health scenarios (common cold, glaucoma, and heart attack) using government and private facilities. Socioeconomic factors like income, education level, and land ownership influenced WTP amounts. WTP was generally higher for more serious illnesses and in government versus private facilities. Improving benefits and establishing payment assistance were recommended to raise ability to pay for medical care.
Running head VULNERABLE POPULATION15VULNERABLE POPULATION .docxagnesdcarey33086
This document discusses vulnerable populations in relation to HIV/AIDS. It identifies several groups that are especially vulnerable, including children living with HIV, homosexuals and transgender groups, and people living in developing countries where HIV is stigmatized. It notes the social, economic, and political challenges faced by those living with HIV, such as discrimination, lack of access to healthcare and treatment, and laws prohibiting education about prevention. The document proposes a community program to address these barriers and help provide testing, prevention, treatment, and care for all people affected by HIV/AIDS.
Psycho (Alfred Hitchcock, 1960)RUNNING HEAD Community H.docxwoodruffeloisa
Psycho (Alfred Hitchcock, 1960)
RUNNING HEAD: Community Health Program (CHP)
Community Health Program (CHP)
Community Health Program
Jennifer Coble, Emley Jennifer Tenorio, Mary Walsh
HCA-620
January 8th, 2020
The American Heart Association and hypertension
Introduction
The American Heart Association and hypertension is a non-profit making organization that is mandated by the federal government to create a medical awareness program about heart and hypertension conditions among the United States residents. The main aim of initiating this activity is to help in solving health issues relating to heart and hypertension cases that are currently common in different parts of the United States.
DESCRIPTION OF SERVICES
The American Heart Association and hypertension program aim at creating outreach awareness about heart diseases and disorders and hypertension conditions. The process of creating public awareness will tend to reach a large number of people from areas to inner cities where most people reside. A mobile health care promotion program will use a public address to announce to invite the public to come for free heart and hypertension screening. The screening process will involve testing members of the public who will make to mobile screening centers.
Currently, there are various cases relating to heart and hypertension cases in different states in the United States. Statistically, the aging population is the most affected groups which have been reporting cases of heart and hypertension disorders. Usually, it is challenging to detect these conditions at early stages (Huebner, Milgrom, Mancl, Smolen, Sutherland, Weinstein & Riedy, 2014). As such, this has led to many deaths since many cases are detected when the disease is at an advanced stage, which is challenging to treat. Therefore, this program is essential because it will help in assisting members of the public in knowing whether they are suffering from such conditions. In doing so, this will help to initiate early medical actions to help in reducing the number of deaths associated to heart and hypertension conditions.
Description of Mobile Health Promotion Outreach Program
Community Health Programs (CHPs) are increasingly regarded as an integral component of primary healthcare (Schneider, 2019). The organizations senior leadership asked a team of medical professionals to put together a mobile health promotion outreach program able to reach a diverse population from inner-city areas to rural communities with a focus on promoting and providing screening activities for The American Heart Association (AHA) and Hypertension. AHA is the world’s leading voluntary organization dedicated to building healthier lives, free of cardiovascular diseases, and partner in building healthier communities (2018). AHA branded health screenings conducted at a community-based health events designed to help consumers become aware of their personal health risk factors, ...
Us Helping Us is a nonprofit organization committed to improving health and well-being of Black gay men and reducing HIV/AIDS impact in the Black community. It began as a self-help group for HIV+ Black gay men and has expanded to serve gay/bisexual men, heterosexual men and women, transgender persons, and youth. Services include mental health, HIV testing, health screenings, case management, support groups, and HIV prevention. Opportunities exist to expand volunteer programs, attract physician volunteers, pursue new funding sources, and strengthen collaborations to further serve clients.
A new health and development paradigm post-2015: grounded in human rightsLisa Hallgarten
Marge Berer, Editor of RHM, presentation at meeting
Divided we stand? Universal health coverage and the unfinished agenda of the health MDGs
Institute of Tropical Medicine, Antwerp February 11th 2014
Project Proposal Example
Ethos In A Modest Proposal
Health Care Proposal Essay
Crime Research Proposal
Sample Grant Proposal Essay
Sample Proposal Letter Essay
Project Proposal Essay
Proposal for Final Project
A Modest Proposal Summary
Health Financing Functions: Risk PoolingHFG Project
Presentation by Dr. Elaine Baruwa, Abt Associates, at Haiti's International Conference on Access to Health Care for All in Haiti: Challenges and Perspectives for Funding, April 28-29, 2015, Haïti
You should respond to at least two of your peers by extending- refutin.docxjosee57
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.
Post #1
Jenna Horgan
NUR 420
Professor Roberts
January 12, 2023
Who are the clients in Community Health nursing?
Individuals, families, and groups who live in a specific geographic area and may be at risk for health problems or in need of health services are considered clients in community health nursing. People of all ages, from infants to the elderly, as well as those with physical, mental, or social challenges, may be included. The purpose of community health nursing is to promote the health and well-being of the entire community by addressing the health needs of its individual members (Rector & Stanley, 2021). Community health nurses work with clients to identify and address health risks, provide health and wellness education, and connect clients to suitable health services.
What government resources might they be eligible for?
Individuals and families may be eligible for a variety of government resources depending on their circumstances. Some of these resources are intended specifically for people with low incomes or who are experiencing financial hardship, while others are open to anyone who meets certain criteria. Among the resources available to them are (ISPOR, n.d):
1. Medicaid: It is a federal-state partnership program that provides health insurance to low-income individuals and families. Individuals must meet income and asset limits, as well as other requirements, to be eligible.
2. Children's Health Insurance Program (CHIP): It is a federally funded program that provides health insurance to low-income children that are not eligible for Medicaid but cannot afford private health insurance. It provides coverage for a variety of medical services, such as preventive care, doctor visits, hospital stays, and prescription medications. Eligibility is determined by income and family size.
3. Supplemental Nutrition Assistance Program (SNAP): It is also known as food stamps and it provides financial assistance to low-income individuals and families in order for them to purchase food. Income and assets, as well as other factors, determine SNAP eligibility.
4. Temporary Assistance for Needy Families (TANF): This program helps low-income families with children by providing financial assistance as well as other services such as job training and childcare. Income and assets, as well as other factors, determine TANF eligibility.
5. Low Income Home Energy Assistance Program (LIHEAP): It is program funded by the federal government that provides low-income households with financial assistance to help them pay for home energy costs such as heating and cooling. The Department of Health and Human Services (HHS) administers the program, which is intended to assist households that are struggling to pay their energy bills and may face having their service disconnected. Eligibility is determined by income and family size.
What ag.
A tremendous need exists to engage hard-to-reach populations in HIV/AIDS care. That’s because numerous factors prevent people living with HIV/AIDS (PLWHA)—especially disadvantaged and disproportionately affected populations—from engaging in care or remaining in care.
This Webcast introduces providers to several successful strategies for reaching the most vulnerable populations:
Howell Strauss, DMD, AIDS Care Group, discusses traditional street outreach, as well as his involvement with both the SPNS Oral Health Initiative and the SPNS Jail Initiative.
Lisa Hightow-Weidman, MD, MPH, Department of Infectious Diseases University of North Carolina at Chapel Hill, shares best practices in social marketing outreach in the context of her work as a SPNS Young Men who Have Sex with Men of Color Initiative grantee.
Program evaluation: Philadelphia Fight’s Youth Health Empowerment Program (Y-...Antar T. Bush. MSW, MPH
HIV/AIDS has been serious public health issue facing the city of Philadelphia for the last two decades. According the AIDS Activities Coordinating Office, there are approximately 30,000 individuals living with HIV/AIDS in Philadelphia (AACO, 2012). This average is slightly higher than other major cities in the United States. AACO states the most vulnerable population is young men who have sex with men of color (MSM) between the ages of 15 and 25. This young population makes up for 56% of all new diagnosis of in the city (AACO, 2012). It is imperative for Philadelphia Fight to stay innovative with their approach to tackling sexual health issues that face this city. One major way Philadelphia Fight is addressing is epidemic is through opening the Youth Health Empowerment Project (Y-HEP).
Community Health Financing as a Pathway to Universal Health Coverage: Synthes...HFG Project
Community-based health insurance (CBHI) emerged in West Africa the 1990s as a grassroots response among rural and poor communities to fees charged by private and public clinics and hospitals. Three countries – Ghana, Senegal, and Ethiopia – have leveraged CBHI in different ways to expand publicly funded coverage to the informal sector in rural and urban settings. This paper synthesizes the experiences from these three countries to illustrate the role that CBHI can play in UHC.
Community Health Financing as a Pathway to Universal Health Coverage: Synthes...
Dorce Final Draft PST 320
1. Dorce 1
Glorianne Dorcé
PST: 320:01
S. Sieck & B. Graham
December 11, 2015
The Western Hemisphere's Epidemic:
Analyzing Haiti's Future Providing HIV medicine to its People
Abstract
This paper is used to assist academic audience of policy analysts or policy makers on
evaluating the best alternative for a foreign country such as Haiti. Compared to HIV in Africa, it
is a much smaller problem in the Western Hemisphere. Nonetheless, Haiti has 120,000 people
living with HIV, making Haiti face an epidemic (Avert, 2011 and 2012, Caribbean HIV & Aids
statistics). Now, the main topic of the paper is to explain on how Haiti is facing an HIV epidemic
where their government is unable to provide medicine to the patients. Haiti being ranked as one
of the top 30 countries with the highest percentage of population living with HIV, one wonders
on why they are not getting better access towards medicine (CIA, 2014). The policies evaluated
in this case will depend on the influence they have on the percentage of HIV patients getting
treated, the cost-effectiveness and feasibility of implementing said policies.
Problem Definition
A good thing however is that HIV can be controlled by providing triple drug
antiretroviral therapy (ART), but the drug is very expensive (Deschamps, 2000). The problem in
Haiti at the moment is that HIV patients in Haiti are having trouble in accessing to medicine.
Firstly, the population is too poor to buy the ART on their own. Furthermore, the government is
lacking resources to afford the drugs, let alone distribute them, reason for this is that Haiti is
ranked 150th out of 175 countries in income (Edmonds, 2012). The government is also unable to
fund doctors whom may prescribe the medication to the patients. In fact, there is less than one
2. Dorce 2
doctor per eight-thousand people in Haiti (Ersegovina, 2015), which is twenty times less than
that of the United States (World Bank, 2011). Analysis has also been done by The World Health
Organization displaying the average population covered per primary health facility in 2008
(Figure 1). On the other hand, another factor contributing to Haiti’s problem is that they face
democratic reconstruction every few years, providing major questions on how
feasible implementing a policy through the state would be.
Figure 1: World Health organization data on 2008 estimated Average population covered per primary health
facility.
The government in Haiti needs to find a solution that will assist them in providing
accessibility to HIV medication for their citizens. The lack of resources and fluctuating
government however will make it difficult in finding a policy that would assist in addressing the
demanding needs of HIV patients. The solution is finding another method in getting the
medication distributed to the HIV population. This may be done by implementing policies that
assists institutions and pharmaceutical companies in providing sufficient amounts of medication
for HIV patients. If the Haitian government is still incapable of supplying medication to the HIV
3. Dorce 3
patients or even a substitute solution then the HIV epidemic will continue a few more
years.
Criteria
In order for the government to implement a policy that will assist in providing HIV
medicine to its people, there must be a few standards that assess how the alternatives may impact
the country. The criteria will be on: percentage of HIV patients getting treated, the cost-
effectiveness, and feasibility of policy being implemented. The percentage of patients receiving
treatment (“HIV treated”) will demonstrate on how effective the alternative policies have been in
providing treatment to the Haitian HIV population. “Cost-effectiveness”, so that the alternative is
favorable, the policy must have a high percentage of HIV patients receiving treatment at a lower
cost than the other alternatives. Lastly, feasibility of a policy being implemented (“Feasibility”)
predicts the possibility of policy being passed by examining the current political, and economic
environment of Haiti. Now, each criteria will have a weight designated, and based on the
weights of each criteria, the alternatives will be evaluated from being the least to most effective
in addressing the problem. Figure 2 displays the weights of each criteria and how the alternative
will be analyzed.
4. Dorce 4
Figure 2. HIV treated (.45) + Cost-effectiveness (0.275) + Feasibility (0.275) = Effectiveness of alternative.
1=least effective, 5= most effective.
Starting with “HIV treated”, increasing the percentage of HIV patients receiving
treatment will conclude that the policy is a successful alternative. The percentage of patients
receiving treatment will be based on patients who have access to antiretroviral therapy (ART).
This percentage will inform how successful the alternative is in providing ART in Haiti. This is
related to our current problem because the goal is to submit a policy that helps people access to
ART.
Additionally, Haiti being poor needs to have stricter control on their money because of
the economic environment they are in now. This makes it important to do a cost-effectiveness
analysis (CEA) can “identify ways to redirect resources to achieve more" for the same cost, such
as providing medicine to the people (Jamison DT, Breman JG, Measham AR, et al, 2006). The
cost-effectiveness will analyze the ratio between the amounts of HIV patients receiving treatment
over the cost of providing the treatment. Consequently, for the alternative to be favorable, the
policy must have a high amount of HIV patients receiving treatment at a lower cost than the
other alternatives.
An equally important independent criteria is known as political feasibility. The feasibility
of a policy is dependent on Haiti's current political environment, key factors being the
5. Dorce 5
country's economic and social standing. The economic and social standing of the government
will help whether or not the government would oppose, remain neutral or advocate for a certain
policy (Meltsner, 1979). Example of this is the government leaning towards a more cost-
effective policy if they are worried of the GDP of their country, or leaning towards an alternative
that has a stronger social impact if they are trying to appease a certain advocacy group.
Understanding the various relationships the government has with their environment and other
key members-clinics, foreign organizations, citizens of Haiti- will identify which trade-offs the
alternatives provide will become more favorable than the next.
Evidence and Alternatives
Alternative 1: Status Quo “Existing state of Affairs in Haiti”
At the moment there is no policy the government is specifically funding for HIV
medicine accessibility. Instead Haiti is dependent on foreign non-governmental organizations
(NGOs) to provide for the lack of resources available. Currently, an NGO called Population
Service International (PSI) created and is funding a program that provides education on sexual
health and distributes contraceptive goods in attempt to prevent unintended pregnancies (PSI,
2015). The program is called Preventing Mother-to-Child Transmission of HIV or PMTCT
program.
The PMTCT program also provides pregnant women free HIV testing, and if declared
positive they supply ongoing psychosocial counseling for the entire family of the pregnant
woman. Furthermore, to prevent an HIV positive mother from transmitting HIV to the child
through breastfeeding, the suggest variations of feeding their child through the educational
classes provided by PMTCT program. A common problem with providing alternative
6. Dorce 6
breastfeeding options is that the majority of the Haitian community believes that if a mother is
unable to breastfeed, than the mother is unfit or handicapped (Gupta, Whelen, and Allendorf,
2006, 25). Nevertheless, if the mother is able to face this stigmatization and follow the PMTCT
program, the PSI will try to provide a clinic that prescribes antiretroviral therapy near the
mother's village through the NGOs network (PSI, 2015).
Currently, PSI is providing all the funding for the program based on the current NGO
networks PSI is connected with. By 2011 around 77% or pregnant women living with HIV in
Haiti had access to services that PMTCT of HIV, which lead to a 25% decrease in the number of
children born with HIV (UNAID, 2012). Furthermore, the impact that the PMTCT program had
with their networking clinics has decreased new HIV by 54%, and AIDS-related deaths at a
steady decline of 47% from 2001-2011 (UNAID, 2012). Based on these results the Haitian
government has high remarks on the effectiveness of the PMTC program funded by PSI and
other foreign NGOs just like it. The cost-effectiveness of the program is even explained by the
Haitian President, Michel Martelly, in which “it costs only US $150 [ funded by NGOs] to
prevent a child being born with HIV, [while] it would cost hundreds of thousands of dollars to
treat a person living with the virus over the course of their lives" (UNAIDS, 2012).
Provided with these results the Haitian government may believe that there is not an issue
with Haiti's government not having funding for HIV medicine accessibility, when Haiti can just
rely on NGOs. Evidence for this is that, more than 75% of funding for Haiti’s HIV response
comes from external sources (UNAID 2012). However, if PSI and the rest of the NGOs for
some reason decided to leave Haiti, who would support the HIV patients in Haiti? Now, if the
government continues to neglect in providing services that may assist HIV patients, it is
7. Dorce 7
questionable on how stable it is being dependent NGOs always providing the services needed to
assist HIV patient’s access to medicine.
Alternative 2: Anti-discrimination Law
Another cause for patients being unable to access medication is the discrimination HIV
patients must face. An option that could be used to reduce discrimination is the government
passing an anti-discrimination law, like the one in Bolivia called Law 045 against Racism and
All Form of Discrimination or “Ley 045 Contra el Racismo y Toda Forma
de Discriminación". The law prohibits discrimination because of social status, sexual orientation,
gender, and race (Bolivia, 2010). This law is essential for Haiti’s socioeconomic imbalance, and
discriminatory views facing both genders with HIV and other such discrimination that may
hinder providing medication to the patients.
In rural Haiti, extreme discrimination occurs when someone is declared HIV positive and
can face ostracism, be blamed for the disease, and denied treatment (Pamela Surkan, 2010).
Example for this type of ostracism and blame for disease is seen in the homosexual community
of Haiti. Many Haitians have a strong faith in Christianity and Voodoo and practice informal
healing procedures (Kidder, 2003). Some believe that HIV can be cured by confessing their sins
to such practices and following faith healing practices (ERZEGOVINA, 2015). Furthermore,
homosexuality being viewed as a sin makes Haitians believe that those who are homosexual
deserve HIV since they are living in sin. This is powerful since an estimated 18% of Haitian men
who have sex with men are living with HIV (UNAID, 2012).
Another form of discrimination on HIV prevention that is highly prevalent in Haiti and
other underdeveloped countries is gender inequality. It appears that gender plays a significant
role on the individuals risk and vulnerability in the HIV/AIDs epidemic (Gupta, Whelen, and
8. Dorce 8
Allendorf, 2002, p.8). In order for Haiti to provide usable access towards HIV medication, there
must be a dialogue created so that both female and male may seek for HIV medication without
fear of being turned down due to their gender. Although, the control women have over their
sexual health and body due to their gender is questionable. After all, only recently the United
States- a developed country- allowed women to make decisions of their own sexual health
through the Women’s Health Protection Act (Draw The Line, 2015).
Considering, both genders receiving equal footing in accessing medication the
government must be able to enforce this alternative police. In which, Haiti must find a way to
avoid the same review Bolivia had from human rights ombudsman “that persons with HIV/AIDs
faced the most discrimination in [Bolivia]” (US Department of State, 2008). A possible method
of enforcing an anti-discrimination law would be training authorities in clinics and NGOs on how to
regulate and enforce the law in their environment. However,in order for the authorities to understand the
consequences for violations of the law is via constructing disciplinary review and corrective action forms
that contain such information.
This law will be structured so that there will be degrees of violations on discrimination. Minor
offenses would be regulated by the district in where the clinic is situated. The district would determine
whether or not there was a violation of the law. If there was discrimination in that area,the employer
would be placed on temporary leave until the case has been designated closed. The violators would be
penalized through warning, paying a fine, probation or possible revocation of working in district or
terminating their position in the clinic. This would call in for Federal Court where the Ministère de la
Santé Publique et de la Populaiton or Ministry of Public Health and Population (MSPP) would
determine whether major offenses had occurred against the law. Major offenses would include a
group of complaints were addressed against the clinic. Some of the qualified offenses would be fraudulent
data on patients being served or lack of educating against discrimination during employee training. The
9. Dorce 9
penalties for these offenses can lead to jail time for the designated employers starting at 5 years or
replacement of the clinic.
Moreover, providing a concise policy on consequences for violation of the anti-
discrimination law will ensure that the abuser of the program will be managed and controlled
efficiently by the establishment ("Enforcement Policy Statement", 2009). Therefore, with the
government passing the anti-discrimination law with enforced regulation, they will promote
and achieve sustained compliance with the law because the law will secure that clinics and
NGOs whom fail to follow their responsibilities shall be held accountable either in court or
through a fine depending on the severity of the violation.
Alternative 3: Reconstruction on transportation
A different blockage of HIV medication Haiti faces, because of 2010 earthquake, is the
loss of the majority of their infrastructure, including clinics and roads. The government must sign
a contract with a foreign country that reconstructs necessary roads to increase medicinal and
structural accessibility. There is also a dire need for isolated villages not near clinics to have
improved roads so that clinics may broaden their reach of HIV patients being able to distribute
their “Van clinics” on a weekly basis efficiently. Additionally, transportation of the HIV
medicine to different clinics would be fast compared to previous years due to the accessibility to
paved roads. Overall, the journey for the patient and drivers to the ART would be less dangerous
and quicker.
However,the government had some opportunities in creating roads across Haiti yet
one notably had lead up to lawsuits. The lawsuits occurred because reconstructing the transportation
network in Haiti is complicated by an inadequate land titling system (Ferriera,2013). In order for
this alternative to become feasible the Haitian government must increase the control the National Land
10. Dorce 10
Registry Office (ONACA) has in receiving and organizing said land tittles into the system so that the
disputes will not occur.
Another question about the feasibility of implementing this alternative is question on why a
country would want to invest in Haiti. One of the main reasons to invest in Haiti would be creating
political with Haiti. A strong contender on that would be seen through the example from China. Reason
for this is that Haiti is one of the twenty-five countries left in the world that has diplomatic relations with
Taiwan lieu of the People’s Republic (Moody, 2010). In fact,china was the first to reach Haiti in
providing a 125 member search-and-rescue team,aid supplies and medics when the earthquake in 2010
(Embassy of People's Republic of China in United States, 2015). It is also possible for China to
have a stronger influence in creating relations with Haiti versus the United States because they
are trying to avoid the imperialistic/colonial approach of a better country offering “foreign aid”.
This is good since Haiti is well known in having pride of being the second independent nation in
Americas and being done through a “negro-slave” revolt ( History.com Staff, 2010). Instead,
China is trying to offer help to it is familial country in their time of need by not providing
excessive amount of debt or loans and creating a contract between partners (Moody, 2010).
Moreover, some critics about this alternative claim that initially the cost would be too
high- $1.96 billion- since the government would have to rebuild instead of improve roads due to
the earthquake from 2010. Although, if the Haitian government can implement the increase of
roads and transportation, the roads would create jobs and the overall productivity growth would
increase (Bureau of Transportation Statistics, 2015). Increasing the jobs and productivity of Haiti
will increase in the overall economy. This suggests that over time the trade-offs of spending now
in the country's economy will increase the welfare of the HIV patients and overall country in the
future.
11. Dorce 11
Alternative 4: Implementing HIV education
This alternative policy will be implementing sexual education in schools to help
educate young adults on how HIV is transmitted, how HIV can be prevented and how their
gender roles influence their roles in the spread of HIV. This is a challenge in providing access to
medication because there is only a literacy rate of 60.7% in the entire country's population (CIA,
2015). Although, the importance for this alternative to be implemented is that there is a
considerable amount of youth who are at risk of contracting HIV due to their lack of HIV
education. Education being one of the key factors in preventing HIV makes it considerably
important for the Haitian government to implement a policy that will help create a program on
educating civilians about HIV (Jukes and Dessai, 2005).
Although, poverty in Haiti is making both males and females vulnerable to HIV by
decreasing access of services, like education. This makes it difficult to create a system were the
government can regulate the progress of the program, and pay the sufficient amount of income
for the teachers to provide extra information other than the ones the teachers are trying to teach (
Emmerson, 2011). Critics may question if there is a satisfactory amount of educators who can
provide the teenagers with the HIV information, when Haiti only has a literacy rate of 60% in the
entire country (Emmerson, 2011)? Would the role then have to be forced upon the health
institutions, or the health organization, or could it be possible that they might want to work with
one another (Gupta et. al, 2002, p. 44)? Some suggest that since there are very few educators in
Haiti that this should be enforced by the NGOs.
An example of such a program was established in Uganda, yet implemented by the
government, was called "Abstinence, be faithful, use a condom" campaign or ABC
strategy (Bendavid, 2009).The ABC strategy does appear successful for it was credited in
12. Dorce 12
decreasing the percentage of AIDS by 10% from 1990 to 2001 in Uganda (Murphy et. al, 2006).
However, by preaching abstinence, the loss of virginity will further increase and support
"negative social sanctions associated with [it]" (Gupta et. al, 2002, p.21). Resulting to teenagers’
curiosity and ability to ask about sexual information almost taboo, let alone HIV.
There was further criticism on this policy strategy because the question whether ABC
was truly responsible for Uganda’s decline in HIV. One of the main points was written by Elain
Murphey and her co-authors stating that there is a well-documented admittance of sexual
violence against women and it is a risk factor for HIV (2006). Haiti may be a religious country,
there is still rape occurring whether one is practicing “Abstinence” or not. Simultaneously, one
of the highest risk groups in Africa were neglected in the ABC strategy based on the "Be
faithful": monogamous married women (Murphy et. al, 2006). Analyzing virtue of sexually
transmitted infections among married men are highly incidental because of extramarital sexual
activity due to recent surveys performed (Murphey et. al, 2006).
Even though there is a sub-population that is being neglected in this strategy, the
education will be focused on pre-teens ranging from 12-15 where one can assume that these
children are not yet mothers. Distinguishing the age category of where the education will be
focused on allows for the policy providing all the government's efforts in
implementing HIV education to that age group. Based on these changes provided by the ABC
strategy, the Haitian government may use the program as a template that supports their strong
values in religion yet informative and affordable.
Overall Outcomes of Alternatives
An outcomes matrix was created based on the evidence provided from each of the
alternatives. The outcomes matrix evaluated the alternatives based on how well the policies
13. Dorce 13
addressed the problem through the criteria (Figure 3). It is safe to conclude that based on the
criteria both sexual health education and reconstruction on transportation would be useful in
assisting the Haitian government in providing HIV patients accessibility towards medication.
Dependent on the government’s situation one may choose either or both. Reason for this is that
between the two alternatives sexual health education is the best alternative in cost-effectiveness
while the reconstruction on transportation has better political feasibility.
Figure 3: Based on the weights of each criteria, the alternatives were evaluated from being the least effective
(1) to the most effective (5) in addressing the problem through the criteria. Total results represents the overall
outcome of the alternative. HIV treated (.45) + Feasibility (0.275) + Cost-effectiveness (0.275) = Total results.
Discussion
The desired state after one of the following alternatives was chosen was help government
to increase the amount of HIV Medicine being provided to patients leading to better regulation
on HIV epidemic. From the results of the outcome matrix it appears that both the sexual
education and reconstruction of infrastructure would be best in helping the government reach the
14. Dorce 14
desired state. Based on the economic and social environment it would be interesting on which of
the alternative policies the government would choose.
At first, it was planned to use only one alternative policy yet from this data it would be
interesting to do further research and see how combined policies would alter the results in
assisting in providing HIV medication to the patients in Haiti. If the government would prefer to
have a finite example of how the policies can be implemented there can be further research done
by performing a pilot study. In the pilot study, instead of implementing the entire law in the
entire country, the government can try working with the NGOs. Working with NGOs first allows
the government to see how the alternatives would affect a program like PMTCT. Although by
focusing on a specific program, it allows the government to not invest too much money in a
policy that might not work. Furthermore, the government can put their mark on the program to
include the interest of their citizens and themselves.
Whether Haiti chooses an alternative or not for this pilot study of federal announcement,
the one that the government uses will bring some powerful trade-offs both political and
economic. The question that will be answered overtime is whether or not their choice was the
best alternative for their current epidemic. Through the outcome matrix it appears that the
government will not decrease the accessibility of medication to their people. This is a plus since
the overall goal was to improve the accessibility of HIV therapy to the Haitian people.
16. Dorce 16
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