public health

1. Lecture two
Society And health
Kabombo BSc P.H

2. Introduction
The relationship between society and health is complex and multifaceted.
Social Determinants of Health
1. Economic stability: Income, employment, and financial security impact health
outcomes.
2. Education: Access to education and educational attainment influence health
literacy and decision-making.
3. Social support: Strong social connections and support networks contribute to
mental and physical well-being.
4. Healthcare access: Availability and accessibility of healthcare services affect
health outcomes.
5. Environmental factors: Living conditions, air and water quality, and exposure to
pollutants impact health.

3. Societal Factors Influencing Health
1. Cultural norms: Cultural values and norms shape health behaviors
and attitudes.
2. Social inequality: Disparities in income, education, and access to
resources contribute to health inequities.
3. Urbanization: Urban environments can influence physical activity,
diet, and mental health.
4. Technology: The impact of technology on health, including screen
time, social media, and access to health information.
5. Policy and legislation: Laws and policies can influence health
outcomes, such as tobacco control, food safety, and healthcare access.

4. Health Outcomes
1. Maternal and child health: Societal factors influence birth outcomes,
infant mortality, and child development.
2. Chronic diseases: Social determinants contribute to the development
and management of chronic diseases, such as diabetes and heart disease.
3. Mental health: Societal factors, including stigma and support, impact
mental health outcomes.
4. Infectious diseases: Social determinants, such as access to healthcare
and vaccination rates, influence the spread of infectious diseases.
5. Injury and violence: Societal factors, including crime rates and access
to safety nets, contribute to injury and violence.

5. Interventions and Solutions
1. Public health initiatives: Programs and policies aimed at promoting health
and preventing disease.
2. Community-based interventions: Initiatives targeting specific communities
or populations.
3. Healthcare system improvements: Enhancing healthcare access, quality,
and coordination.
4. Social and economic policies: Policies addressing income inequality,
education, and social support.
5. Research and evaluation: Studies examining the relationship between
society and health, informing evidence-based interventions.

6. Global Perspectives
1. Global health disparities: Differences in health outcomes and access to healthcare across countries
and regions.
2. International health initiatives: Global efforts to address health challenges, such as pandemics and
humanitarian crises.
3. Cultural exchange and collaboration: Sharing knowledge and best practices across cultures and
countries.
4. Human rights and health: The relationship between human rights, dignity, and health outcomes.
Future Directions
1. Precision public health: Using data and technology to target interventions and improve health
outcomes.
2. Social and behavioral sciences: Integrating social and behavioral sciences into public health
practice.
3. Global health security: Addressing emerging health threats and promoting global health stability.
4. *Health equity: Focusing on reducing health disparities and promoting health equity.

7. Factors influencing health service
delivery
• Health service delivery is influenced by a complex array of factors, which
can be broadly categorized into several key areas:
• Healthcare System Factors
• 1. Healthcare infrastructure: Availability and quality of healthcare facilities,
equipment, and technology.
• 2. Healthcare workforce: Availability, distribution, and skills of healthcare
professionals.
• 3. Healthcare financing: Funding models, payment structures, and insurance
coverage.
• 4. Healthcare policies and regulations: Laws, regulations, and policies
governing healthcare delivery.

8. Patient-Related Factors
1. Demographic characteristics: Age, sex, socioeconomic status, and cultural background.
2. Health status: Physical and mental health conditions, comorbidities, and functional status.
3. Healthcare needs: Patients’ perceived needs and expectations.
4. Adherence to treatment: Patients’ ability and willingness to follow treatment plans.
Environmental and Social Factors
1. Geographic location: Rural vs. Urban, accessibility, and transportation options.
2. Social determinants of health: Economic stability, education, social support, and
environmental factors.
3. Cultural and linguistic diversity: Language barriers, cultural differences, and healthcare
provider-patient interactions.
4. Community resources: Availability of community-based services, support groups, and
social services.

9. Technological Factors
1. Electronic health records: Adoption and use of electronic health records (EHRs) and other digital
health technologies.
2. Telemedicine: Use of telehealth and remote monitoring technologies.
3. Health information exchange: Sharing of health information across healthcare providers and
systems.
4. Digital health literacy: Patients’ ability to access, understand, and use digital health information.
Organizational and Management Factors
1. Healthcare leadership and governance: Leadership styles, management structures, and
organizational culture.
2. Quality improvement initiatives: Efforts to improve healthcare quality, safety, and patient
satisfaction.
3. Healthcare operations: Management of healthcare services, including scheduling, staffing, and
supply chain management.
4. Healthcare innovation: Adoption and implementation of new technologies, treatments, and care
models.

10. Policy and Regulatory Factors
1. Healthcare policy: Laws, regulations, and policies governing
healthcare delivery.
2. Accreditation and certification: Standards and processes for ensuring
healthcare quality and safety.
3. Healthcare financing and reimbursement: Payment structures,
insurance coverage, and reimbursement models.
4. Public health initiatives: Government-led initiatives to promote
health, prevent disease, and protect populations.

11. Provision of health care
The provision of healthcare involves the delivery of medical services to individuals and communities.
Types of Healthcare Provision
1. Primary care: First-level, general healthcare services provided by primary care physicians, nurse practitioners, or other healthcare
professionals.
2. Secondary care: Specialized healthcare services provided by specialists, such as hospitals, clinics, or private practices.
3. Tertiary care: Highly specialized healthcare services, such as organ transplants, cancer treatment, or neurosurgery.
4. Quaternary care: Highly specialized and complex healthcare services, such as experimental treatments or rare disease management.

12. Healthcare Providers
1. Physicians: Medical doctors who provide primary, secondary, or tertiary
care.
2. Nurses: Healthcare professionals who provide primary, secondary, or
tertiary care, often working alongside physicians.
3. Allied health professionals: Healthcare professionals, such as physical
therapists, occupational therapists, or speech therapists, who provide
specialized services.
4. Community health workers: Trained individuals who provide basic
healthcare services, health education, and support in community settings.

13. Healthcare Settings
1. Hospitals: Acute care facilities providing 24-hour care for
patients.
2. Clinics: Outpatient facilities providing primary or specialized
care.
3. Private practices: Individual or group practices providing
primary or specialized care.
4. Community health centers: Facilities providing primary care,
health education, and support services to underserved populations.

14. Healthcare Services
•
• 1. preventive care: Services aimed at preventing illness or injury, such
as vaccinations, screenings, or health education.
• 2. Diagnostic services: Tests and procedures used to diagnose medical
conditions, such as laboratory tests or imaging studies.
• 3. Therapeutic services: Treatments aimed at managing or curing
medical conditions, such as medications, surgery, or physical therapy.
• 4. Rehabilitative services: Services aimed at restoring function or
improving quality of life for individuals with disabilities or chronic
conditions.

15. Healthcare Financing
• 1. Health insurance: Private or public insurance programs that cover
healthcare costs.
• 2. Government programs: Government-funded programs, such as
Medicare or Medicaid, that provide healthcare coverage.
• 3. Out-of-pocket payments: Direct payments made by individuals for
healthcare services.
• 4. Donations: Funding provided by charitable organizations or
government agencies to support healthcare services.

16. Healthcare Regulation and Policy
• 1. Government regulations: Laws and regulations governing healthcare
services, such as licensure and accreditation.
• 2. Healthcare policy: Government policies and initiatives aimed at
improving healthcare access, quality, and affordability.
• 3. Professional standards: Standards and guidelines established by
professional organizations to ensure high-quality care.
• 4. Accreditation and certification: Processes used to evaluate and
recognize healthcare providers and facilities that meet established
standards.

17. Healthcare Technology
1. Electronic health records: Digital records of patient health information.
2. Telemedicine: Remote healthcare services provided through technology, such as video
conferencing.
3. Medical devices: Equipment and devices used to diagnose or treat medical conditions.
4. Health information exchange: Sharing of health information between healthcare providers and
organizations.
Challenges in Healthcare Provision
1. Access to care: Barriers to accessing healthcare services, such as cost, location, or availability.
2. Healthcare workforce shortages: Shortages of healthcare professionals, particularly in underserved
areas.
3. Healthcare financing: Challenges related to funding healthcare services, including reimbursement
models and insurance coverage.
4. Quality and safety: Ensuring high-quality, safe care, including reducing medical errors and
hospital-acquired infections.

18. Zambia’s health reforms
• Zambia’s health reforms are centered around achieving Universal Health Coverage
(UHC) through a comprehensive Health Financing Strategy (HFS) developed by the
Ministry of Health. The strategy, which runs from 2017 to 2027, aims to improve
healthcare financing, making it more sustainable, equitable, and efficient.¹
• *Key Objectives:*
• - *Increase Resource Mobilization*: Boost government funding for healthcare and explore
alternative revenue sources, such as “sin taxes” on products like tobacco and alcohol.
• - *Improve Efficiency*: Enhance resource allocation, reduce waste, and promote public-
private partnerships to optimize healthcare delivery.
• - *Risk Pooling and Redistribution*: Implement a Social Health Insurance (SHI) scheme to
ensure financial protection for citizens and reduce out-of-pocket expenses.
• - *Strategic Purchasing*: Develop a framework for purchasing healthcare services,
focusing on quality and cost-effectiveness.
•
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19. Strategic Interventions
Revenue Collection*: Advocate for increased government
funding, introduce “sin taxes,” and broaden private sector
participation in healthcare financing.
- Pooling of Funds: Harmonize external financing, enhance
complementarity of revenue sources, and set up an internal
tracking mechanism for external resources.
- Purchasing Mechanism: Develop an essential healthcare
package, accredit health facilities, and introduce performance-
based financing to incentivize quality service delivery.

20. • Wishing you all the best