The document discusses WHO and working for WHO. It begins by outlining that the views expressed are those of the individual presenter and not necessarily WHO's official views. It then provides an overview of WHO as an organization, including that it is a UN agency established in 1948 with 194 member states and headquarters in Geneva. The rest of the document discusses Universal Health Coverage (UHC), what it means to achieve UHC, and advice for those interested in global health careers.
2 tool to estimate patient costs literature review_finalAira Bhabe
This document provides a literature review and conceptual framework for developing a tool to estimate patient costs of tuberculosis. It discusses approaches used to measure the cost of illness, including direct costs like medical expenses and indirect costs from lost income. The review found studies on patient costs in various stages: before diagnosis, during diagnosis/pre-treatment, and during treatment. Developing the cost estimation tool will help programs understand economic barriers patients face and design interventions to reduce costs and alleviate poverty. The tool aims to assess the impoverishing impact of tuberculosis and establish evidence for poverty reduction strategies.
Australia spends much more on health care expenditure than on health promotion and prevention. Only 1.7% of total health expenditure in 2011-12 went to public health activities focused on prevention. However, chronic diseases place a large burden on the health system and are often preventable. More funding for prevention strategies could help control rising health costs by reducing rates of chronic illness. While some progress has been made, Australia still spends less on prevention than many other developed countries. Increased investment in primary care and prevention is needed to adequately address challenges from chronic diseases and an aging population.
The People’s Republic of China has made great achievements in improving health status over the past six decades, mainly due to the government’s commitment to health, provision of cost effective public health programmes, growing coverage of health financial protection mechanisms and investments in an extensive health-care delivery network.
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Fuzzy Bi-Objective Preventive Health Care Network DesignGurdal Ertek
Preventive healthcare is unlike healthcare for a cute ailments, as people are less alert to their unknown medical problems.In order to motivate public and to attain desired participation levels for preventive programs,the attractiveness of the healthcare facility is a major concern.Health economics literature indicates that attractiveness to a facility is significantly influenced by proximity of the clients to it.Hence attractiveness is generally modeled as a function of distance.However, abundant empirical evidence suggests that other qualitative factors such as perceived quality, attractions nearby, amenities, etc. also influence attractiveness. Therefore, are alistic measures hould in corporate the vagueness in the concept of attractiveness to the model.The public policymakers should also maintain the equity among various neighborhoods, which should be considered as a second objective.Finally, even though general tendency in the literature is to focus on health benefits,the cost effectiveness is still a factor that should be considered.In this paper,a fuzzy bi-objective model with budget constraints of the problem is developed.Later,by modelling the attractiveness by means of fuzzy triangular numbers and treating the budget constraint as a soft constraint, a modified (and more realistic)version of the model is introduced. Two solution methodologies, namely fuzzy goal programming and fuzzy chance constrained optimization are proposed as solutions.Both the original and the modified models are solved within the framework of a case study in Istanbul,Turkey.In the case study,the Microsoft Bing Map is utilized in order to determine more accurate distance measures among the nodes.
http://ertekprojects.com/gurdal-ertek-publications/
https://link.springer.com/article/10.1007/s10729-014-9293-z
Japan was one of the first countries to be hit by COVID-19 and declared a state of emergency by April 2020. Japan’s response to COVID-19 included the imposition of context-specific measures and restrictions based on local need to contain the spread of the disease. Containment measures were enacted under the Act on Special Measures for Pandemic Influenza and New Infectious Diseases Preparedness and Response. Citizens were requested to abide by containment measures that focused on avoiding the 3C’s: Closed spaces with poor ventilation; Crowded places; Close‐contact settings. Health infrastructure, workforce, and supply chain were strengthened, alongside social security interventions including financial support for citizens. Primary health centers were strengthened and were at the forefront of Japan’s COVID-19 response at the local level.
This publication presents the various measures that were put in place from the beginning of the outbreak until December 2020 to control COVID-19 transmission in the country. We aim to update this document as new policies and interventions are operationalized to respond to the outbreak.
This is primarily based on a chapter from our most recent publication.
I want to acknowledge the authors of the chapter:
Melisa Tan, Victoria Haldane, Sue-Anne Toh & Helena Legido-Quigley from NUS
Martin McKee from LSHTM
Summary of the current 4 main NCDs situation in Asia including risk factors
Examples of health system response
Challenges
2 tool to estimate patient costs literature review_finalAira Bhabe
This document provides a literature review and conceptual framework for developing a tool to estimate patient costs of tuberculosis. It discusses approaches used to measure the cost of illness, including direct costs like medical expenses and indirect costs from lost income. The review found studies on patient costs in various stages: before diagnosis, during diagnosis/pre-treatment, and during treatment. Developing the cost estimation tool will help programs understand economic barriers patients face and design interventions to reduce costs and alleviate poverty. The tool aims to assess the impoverishing impact of tuberculosis and establish evidence for poverty reduction strategies.
Australia spends much more on health care expenditure than on health promotion and prevention. Only 1.7% of total health expenditure in 2011-12 went to public health activities focused on prevention. However, chronic diseases place a large burden on the health system and are often preventable. More funding for prevention strategies could help control rising health costs by reducing rates of chronic illness. While some progress has been made, Australia still spends less on prevention than many other developed countries. Increased investment in primary care and prevention is needed to adequately address challenges from chronic diseases and an aging population.
The People’s Republic of China has made great achievements in improving health status over the past six decades, mainly due to the government’s commitment to health, provision of cost effective public health programmes, growing coverage of health financial protection mechanisms and investments in an extensive health-care delivery network.
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Fuzzy Bi-Objective Preventive Health Care Network DesignGurdal Ertek
Preventive healthcare is unlike healthcare for a cute ailments, as people are less alert to their unknown medical problems.In order to motivate public and to attain desired participation levels for preventive programs,the attractiveness of the healthcare facility is a major concern.Health economics literature indicates that attractiveness to a facility is significantly influenced by proximity of the clients to it.Hence attractiveness is generally modeled as a function of distance.However, abundant empirical evidence suggests that other qualitative factors such as perceived quality, attractions nearby, amenities, etc. also influence attractiveness. Therefore, are alistic measures hould in corporate the vagueness in the concept of attractiveness to the model.The public policymakers should also maintain the equity among various neighborhoods, which should be considered as a second objective.Finally, even though general tendency in the literature is to focus on health benefits,the cost effectiveness is still a factor that should be considered.In this paper,a fuzzy bi-objective model with budget constraints of the problem is developed.Later,by modelling the attractiveness by means of fuzzy triangular numbers and treating the budget constraint as a soft constraint, a modified (and more realistic)version of the model is introduced. Two solution methodologies, namely fuzzy goal programming and fuzzy chance constrained optimization are proposed as solutions.Both the original and the modified models are solved within the framework of a case study in Istanbul,Turkey.In the case study,the Microsoft Bing Map is utilized in order to determine more accurate distance measures among the nodes.
http://ertekprojects.com/gurdal-ertek-publications/
https://link.springer.com/article/10.1007/s10729-014-9293-z
Japan was one of the first countries to be hit by COVID-19 and declared a state of emergency by April 2020. Japan’s response to COVID-19 included the imposition of context-specific measures and restrictions based on local need to contain the spread of the disease. Containment measures were enacted under the Act on Special Measures for Pandemic Influenza and New Infectious Diseases Preparedness and Response. Citizens were requested to abide by containment measures that focused on avoiding the 3C’s: Closed spaces with poor ventilation; Crowded places; Close‐contact settings. Health infrastructure, workforce, and supply chain were strengthened, alongside social security interventions including financial support for citizens. Primary health centers were strengthened and were at the forefront of Japan’s COVID-19 response at the local level.
This publication presents the various measures that were put in place from the beginning of the outbreak until December 2020 to control COVID-19 transmission in the country. We aim to update this document as new policies and interventions are operationalized to respond to the outbreak.
This is primarily based on a chapter from our most recent publication.
I want to acknowledge the authors of the chapter:
Melisa Tan, Victoria Haldane, Sue-Anne Toh & Helena Legido-Quigley from NUS
Martin McKee from LSHTM
Summary of the current 4 main NCDs situation in Asia including risk factors
Examples of health system response
Challenges
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.
The document provides an overview of key concepts in health economics, including:
1) It discusses who has access to healthcare based on ability to pay and examines issues of equity, finance, delivery, and outcomes in healthcare systems.
2) It explores expenditures on healthcare as a percentage of GDP and characteristics of the insured population in the US.
3) It introduces basic questions of economic systems that also apply to health economics, such as what and for whom to produce, and how to achieve economic growth with scarce resources.
Disease cost drivers hai apec hlm nusa dua 2013sandraduhrkopp
Healthcare-associated infections (HAIs) occur in hundreds of millions of patients each year globally, causing increased illness, death and costs. HAIs typically involve four types of infections and rates are usually higher in developing countries. HAIs prolong hospital stays by up to 3 weeks and increase costs by USD $4,888 to $11,591 per infection episode. It is estimated that 65-70% of HAIs are preventable. While preventing HAIs requires initial investment, it can free up hospital beds and resources in the long-run, improving outcomes and making more efficient use of limited healthcare funds.
A selection of key indicators from "Health at a Glance 2019: OECD Indicators", released on November 7, 2019. More info at http://www.oecd.org/health/health-at-a-glance.htm.
This document discusses public health surveillance. It begins by defining surveillance and its main components, which include the ongoing collection and analysis of health data to facilitate disease prevention and control. The document then lists the main uses of surveillance data, such as estimating disease burden and evaluating programs. It describes three main sources of surveillance data: individuals, healthcare providers, and environmental conditions. The document outlines the five main steps of surveillance and discusses selecting health problems for surveillance based on factors like disease severity. It also describes different data collection methods, like notifications, surveys, and disease registries. In closing, it outlines the flow of surveillance information between data providers, analysts, and those responsible for public health response and decision-making.
Taiwan has a compulsory social health insurance program called National Health Insurance (NHI) that provides coverage for all citizens. NHI is funded primarily through premiums paid by enrollees. It uses a classification system to determine premiums and has a copayment system with exemptions. Healthcare institutions are paid through contracts with NHI using various payment methods including fee-for-service, pay-for-performance, global budgets, and diagnosis-related groups. NHI has improved access to healthcare but faces ongoing challenges to resources and long-term care.
Health Economics and Health Finance :Jordan Health Policy Directions Musa Ajlouni
This presentation includes general introduction to health economics,the concept of market failure in health, health financing including health insurance and major challenges related to healthcare financing in Jordan and some policy directions to face these challenges.
This document discusses balancing efficiency and equity in health economics. It summarizes Louis Niessen's background and involvement in projects related to neglected tropical diseases. These projects aim to provide evidence on the socioeconomic impact and cost-effectiveness of scaling up control and elimination efforts for neglected tropical diseases. The goal is to reduce morbidity, mortality, and poverty associated with these diseases through increased knowledge and evidence to inform sustainable and equitable scale-up strategies.
Japan has made numerous achievements in health most notably the world’s highest life-expectancy in the past two decades, since its founding Universal Health Insurance System in 1961. However, ageing population with low-fertility rates, stagnating economy, increasing burden of NCDs and growing use of expensive technologies pose the critical challenges in service delivery and financial stability in health. Japan HiT reports current health system reforms undertaken and also recent discussion on paradigm shift to the new system as proposed in Japan Vision: Health Care 2035.
Relationship Between Fiscal Decentralization and Health Care Financing in Uas...Triple A Research Journal
ABSTRACT
This study examined the relationship between fiscal decentralization and health care financing in Uasin Gishu County Kenya, the researcher sought to answer the following research questions; To what extend does the adequacy of decentralized funds influence health care financing in Uasin Gishu County Kenya? How effective was health management team in influencing health care financing in Uasin Gishu County Kenya? How does budgeting and allocation of decentralized funds affect health care financing in Uasin Gishu County Kenya? Lastly, what were the effects of decentralized fund expenditure on health care financing in Uasin Gishu County Kenya? The researcher used ex-post facto research design. Both stratified sampling and random sampling technique was used to select the respondents. The target population for the study was 98 employees working in health department with a sample size of 79 respondents whom comprised of permanent health workers working in the major hospitals in the county. Questionnaires were employed as the major data collection tools. Data were analysed through descriptive statistics and hypothesis is tested by use of chi square. The analysis of the data was done with Statistical package for social science (SPSS) version 20 and the data was presented though use of graphs and tables for clear understanding of the results. The findings from the study therefore rejected the null hypotheses and concluded that there exists statistically significant relationship between adequacy of decentralized funds, management effectiveness and budgetary mechanism and the level of health care financing. This means that whenever the health management team are effective in managing the decentralized funds well, there is an increase in the level of health care financing.
Keywords: Fiscal Decentralization and Healthcare financing
Health economics is a branch of economics concerned with issues related to efficiency, effectiveness, value and behavior in the production and consumption of health and healthcare.
students wonder exactly what health economics is. is it about money in health, more health for the same money ? about health in hospitals or health of the country.
This document provides a draft policy toolkit for building capacity to prevent and control healthcare-associated infections (HAIs) in the Asia-Pacific region. It recommends establishing a comprehensive national framework for HAI prevention, including designating a health agency responsible and establishing advisory committees. It also recommends requiring minimum infection control programs and surveillance/reporting of HAIs at healthcare facilities with oversight at the national level. Additional recommendations include including HAI prevention in facility licensing/accreditation standards, building training capacity through partnerships, and providing financial incentives/disincentives for HAI reduction efforts. The appendix provides examples of national HAI frameworks, advisory committees, and common HAIs like those caused by MRSA, C. difficile, multid
This document provides an overview of health economics. It defines health economics as the study of how scarce resources are allocated for health care and promotion. The document outlines several key areas studied in health economics, including the value of health, determinants of health, demand and supply of health care, economic evaluations, and health care organization and financing. It also discusses positive and normative analyses and concepts related to equity in health care systems.
This review outlines the main organizational, financing, human resources and service delivery features of the health-care system. Although there has been implement in overall health outcomes since the 1990’s the current levels are still below average for the country’s Pacific neighbors. The remoteness of the many rural communities has hampered improvements in health services. This is one of the major challenges that the country faces in order to achieve SDG heath targets by 2030. This Hits highlights steps taken to overcome challenges especially in the face of epidemiological change in disease burden that is slowly taking place in the country.
The document defines health economics as the application of economic principles to the health care system. It discusses key concepts in health economics including supply and demand of health care, costs associated with health care like fixed vs variable costs, and methods of economic evaluation used in health care planning like cost-benefit analysis. The document also outlines factors that influence health expenditures like changing demographics and disease patterns, new technologies, and rising public expectations. Overall, the document provides a broad overview of the basic concepts and scope of health economics as a field of study.
This document outlines Dan Hausman's critique of economic evaluations of health that rely on eliciting and aggregating individual preferences. Hausman argues that preferences are an unreliable guide to the value of health states for several reasons. People's preferences can be distorted by cognitive flaws and irrelevant factors. They are also often uninformed since health states are unfamiliar alternatives. Rather than relying on preferences, Hausman believes health economists should directly evaluate health states based on their effects on well-being, opportunities, autonomy, and other considerations.
2.3 overview of emerging infectious disease issues in the asia pacific region...sandraduhrkopp
This document discusses antimicrobial resistance (AMR) issues in the Asia Pacific region. It notes that AMR is a global crisis and Asia is an epicenter with high resistance rates. Surveillance programs have been established in some countries but more coordination is needed regionally. Awareness campaigns and promoting appropriate antibiotic use are important strategies. National and international policies and regulations are urgently required to control AMR through surveillance, stewardship, infection prevention and vaccination efforts. Regional collaboration through groups like APEC is important to combat the growing threat of AMR.
Maternal mortality remains a significant global issue, with nearly 830 women dying daily from preventable causes related to pregnancy and childbirth. The majority (99%) of maternal deaths occur in developing countries, where access to skilled healthcare is limited. Key factors that influence a woman's risk include her location (rural areas pose higher risk), economic status (poorer communities at higher risk), and age (adolescents at highest risk). While the global maternal mortality ratio has declined 44% between 1990-2015, many countries still show no progress. Reliable data remains scarce but interventions like skilled birth attendance and access to family planning can significantly reduce maternal deaths.
The Thailand HiT reports that sustained political commitment to the health of the population since the 1970s has resulted in significant investment in health infrastructure, in particular primary health care, district and provincial referral hospitals, and strengthened the overall functioning of the Thai health system. After Thailand achieved universal health coverage in 2002, public expenditure on health significantly increased from 63% to 77% and out-of-pocket expense was reduced from 27.2% to 12.4% of the total health spending in 2011.
A presentation for undergrad students visited Wolrd Health Organization (WHO) to understand what universal health coverage (UHC) is and how WHO works for UHC.
Primary Health Care Systems (PRIMASYS): Case Study from Thailand, Abridged ve...Thira Woratanarat
Primary health care systems (PRIMASYS): case study from Thailand, abridged version. WHO 2017.
By Thira Woratanarat, Patarawan Woratanarat, Charupa Lekthip
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.
The document provides an overview of key concepts in health economics, including:
1) It discusses who has access to healthcare based on ability to pay and examines issues of equity, finance, delivery, and outcomes in healthcare systems.
2) It explores expenditures on healthcare as a percentage of GDP and characteristics of the insured population in the US.
3) It introduces basic questions of economic systems that also apply to health economics, such as what and for whom to produce, and how to achieve economic growth with scarce resources.
Disease cost drivers hai apec hlm nusa dua 2013sandraduhrkopp
Healthcare-associated infections (HAIs) occur in hundreds of millions of patients each year globally, causing increased illness, death and costs. HAIs typically involve four types of infections and rates are usually higher in developing countries. HAIs prolong hospital stays by up to 3 weeks and increase costs by USD $4,888 to $11,591 per infection episode. It is estimated that 65-70% of HAIs are preventable. While preventing HAIs requires initial investment, it can free up hospital beds and resources in the long-run, improving outcomes and making more efficient use of limited healthcare funds.
A selection of key indicators from "Health at a Glance 2019: OECD Indicators", released on November 7, 2019. More info at http://www.oecd.org/health/health-at-a-glance.htm.
This document discusses public health surveillance. It begins by defining surveillance and its main components, which include the ongoing collection and analysis of health data to facilitate disease prevention and control. The document then lists the main uses of surveillance data, such as estimating disease burden and evaluating programs. It describes three main sources of surveillance data: individuals, healthcare providers, and environmental conditions. The document outlines the five main steps of surveillance and discusses selecting health problems for surveillance based on factors like disease severity. It also describes different data collection methods, like notifications, surveys, and disease registries. In closing, it outlines the flow of surveillance information between data providers, analysts, and those responsible for public health response and decision-making.
Taiwan has a compulsory social health insurance program called National Health Insurance (NHI) that provides coverage for all citizens. NHI is funded primarily through premiums paid by enrollees. It uses a classification system to determine premiums and has a copayment system with exemptions. Healthcare institutions are paid through contracts with NHI using various payment methods including fee-for-service, pay-for-performance, global budgets, and diagnosis-related groups. NHI has improved access to healthcare but faces ongoing challenges to resources and long-term care.
Health Economics and Health Finance :Jordan Health Policy Directions Musa Ajlouni
This presentation includes general introduction to health economics,the concept of market failure in health, health financing including health insurance and major challenges related to healthcare financing in Jordan and some policy directions to face these challenges.
This document discusses balancing efficiency and equity in health economics. It summarizes Louis Niessen's background and involvement in projects related to neglected tropical diseases. These projects aim to provide evidence on the socioeconomic impact and cost-effectiveness of scaling up control and elimination efforts for neglected tropical diseases. The goal is to reduce morbidity, mortality, and poverty associated with these diseases through increased knowledge and evidence to inform sustainable and equitable scale-up strategies.
Japan has made numerous achievements in health most notably the world’s highest life-expectancy in the past two decades, since its founding Universal Health Insurance System in 1961. However, ageing population with low-fertility rates, stagnating economy, increasing burden of NCDs and growing use of expensive technologies pose the critical challenges in service delivery and financial stability in health. Japan HiT reports current health system reforms undertaken and also recent discussion on paradigm shift to the new system as proposed in Japan Vision: Health Care 2035.
Relationship Between Fiscal Decentralization and Health Care Financing in Uas...Triple A Research Journal
ABSTRACT
This study examined the relationship between fiscal decentralization and health care financing in Uasin Gishu County Kenya, the researcher sought to answer the following research questions; To what extend does the adequacy of decentralized funds influence health care financing in Uasin Gishu County Kenya? How effective was health management team in influencing health care financing in Uasin Gishu County Kenya? How does budgeting and allocation of decentralized funds affect health care financing in Uasin Gishu County Kenya? Lastly, what were the effects of decentralized fund expenditure on health care financing in Uasin Gishu County Kenya? The researcher used ex-post facto research design. Both stratified sampling and random sampling technique was used to select the respondents. The target population for the study was 98 employees working in health department with a sample size of 79 respondents whom comprised of permanent health workers working in the major hospitals in the county. Questionnaires were employed as the major data collection tools. Data were analysed through descriptive statistics and hypothesis is tested by use of chi square. The analysis of the data was done with Statistical package for social science (SPSS) version 20 and the data was presented though use of graphs and tables for clear understanding of the results. The findings from the study therefore rejected the null hypotheses and concluded that there exists statistically significant relationship between adequacy of decentralized funds, management effectiveness and budgetary mechanism and the level of health care financing. This means that whenever the health management team are effective in managing the decentralized funds well, there is an increase in the level of health care financing.
Keywords: Fiscal Decentralization and Healthcare financing
Health economics is a branch of economics concerned with issues related to efficiency, effectiveness, value and behavior in the production and consumption of health and healthcare.
students wonder exactly what health economics is. is it about money in health, more health for the same money ? about health in hospitals or health of the country.
This document provides a draft policy toolkit for building capacity to prevent and control healthcare-associated infections (HAIs) in the Asia-Pacific region. It recommends establishing a comprehensive national framework for HAI prevention, including designating a health agency responsible and establishing advisory committees. It also recommends requiring minimum infection control programs and surveillance/reporting of HAIs at healthcare facilities with oversight at the national level. Additional recommendations include including HAI prevention in facility licensing/accreditation standards, building training capacity through partnerships, and providing financial incentives/disincentives for HAI reduction efforts. The appendix provides examples of national HAI frameworks, advisory committees, and common HAIs like those caused by MRSA, C. difficile, multid
This document provides an overview of health economics. It defines health economics as the study of how scarce resources are allocated for health care and promotion. The document outlines several key areas studied in health economics, including the value of health, determinants of health, demand and supply of health care, economic evaluations, and health care organization and financing. It also discusses positive and normative analyses and concepts related to equity in health care systems.
This review outlines the main organizational, financing, human resources and service delivery features of the health-care system. Although there has been implement in overall health outcomes since the 1990’s the current levels are still below average for the country’s Pacific neighbors. The remoteness of the many rural communities has hampered improvements in health services. This is one of the major challenges that the country faces in order to achieve SDG heath targets by 2030. This Hits highlights steps taken to overcome challenges especially in the face of epidemiological change in disease burden that is slowly taking place in the country.
The document defines health economics as the application of economic principles to the health care system. It discusses key concepts in health economics including supply and demand of health care, costs associated with health care like fixed vs variable costs, and methods of economic evaluation used in health care planning like cost-benefit analysis. The document also outlines factors that influence health expenditures like changing demographics and disease patterns, new technologies, and rising public expectations. Overall, the document provides a broad overview of the basic concepts and scope of health economics as a field of study.
This document outlines Dan Hausman's critique of economic evaluations of health that rely on eliciting and aggregating individual preferences. Hausman argues that preferences are an unreliable guide to the value of health states for several reasons. People's preferences can be distorted by cognitive flaws and irrelevant factors. They are also often uninformed since health states are unfamiliar alternatives. Rather than relying on preferences, Hausman believes health economists should directly evaluate health states based on their effects on well-being, opportunities, autonomy, and other considerations.
2.3 overview of emerging infectious disease issues in the asia pacific region...sandraduhrkopp
This document discusses antimicrobial resistance (AMR) issues in the Asia Pacific region. It notes that AMR is a global crisis and Asia is an epicenter with high resistance rates. Surveillance programs have been established in some countries but more coordination is needed regionally. Awareness campaigns and promoting appropriate antibiotic use are important strategies. National and international policies and regulations are urgently required to control AMR through surveillance, stewardship, infection prevention and vaccination efforts. Regional collaboration through groups like APEC is important to combat the growing threat of AMR.
Maternal mortality remains a significant global issue, with nearly 830 women dying daily from preventable causes related to pregnancy and childbirth. The majority (99%) of maternal deaths occur in developing countries, where access to skilled healthcare is limited. Key factors that influence a woman's risk include her location (rural areas pose higher risk), economic status (poorer communities at higher risk), and age (adolescents at highest risk). While the global maternal mortality ratio has declined 44% between 1990-2015, many countries still show no progress. Reliable data remains scarce but interventions like skilled birth attendance and access to family planning can significantly reduce maternal deaths.
The Thailand HiT reports that sustained political commitment to the health of the population since the 1970s has resulted in significant investment in health infrastructure, in particular primary health care, district and provincial referral hospitals, and strengthened the overall functioning of the Thai health system. After Thailand achieved universal health coverage in 2002, public expenditure on health significantly increased from 63% to 77% and out-of-pocket expense was reduced from 27.2% to 12.4% of the total health spending in 2011.
A presentation for undergrad students visited Wolrd Health Organization (WHO) to understand what universal health coverage (UHC) is and how WHO works for UHC.
Primary Health Care Systems (PRIMASYS): Case Study from Thailand, Abridged ve...Thira Woratanarat
Primary health care systems (PRIMASYS): case study from Thailand, abridged version. WHO 2017.
By Thira Woratanarat, Patarawan Woratanarat, Charupa Lekthip
HEALTH SITUATION The population of the country has incr.docxAASTHA76
HEALTH SITUATION
The population of the country has increased by 45.8% in the past 25 years, reaching 29.9 million in
2015. It is estimated that 17.5% of the population lives in rural settings (2012), 17.2% of the
population is between the ages of 15 and 24 years (2015) and life expectancy at birth is 76 years
(2012). The literacy rate for youth (15 to 24 years) is 99.2%, for total adults 94.4% (2013), and for
adult females 91.4% (2012).
The burden of disease (2012) attributable to communicable diseases is 12.6%, noncommunicable
diseases 78.0% and injuries 9.4%. The share of out-of-pocket expenditure was 19.8% in 2013 and
the health workforce density is 26.5 physicians and 53.73 nu rses and midwives per 10 000
population (2014).
HEALTH POLICIES AND SYSTEMS
The National Transformation Program 2020 identifies interventions for health system
strengthening, health promotion and control of noncommunicable diseases, control of
communicable diseases, health security, and improving partnerships for health development. In
addition, the National Transformation Program 2020 aims to improve the planning, production
and management of the health workforce. It has also prioritized the growing private sector with a
focus on better regulation and public–private sector partnerships. Promoting health in all policies
and greater intersectoral collaboration at national and subnational levels have been identified as
national priorities for the current planning cycle. Decentralization needs strengthening and the
strategy has identified mechanisms for empowering the subnational level. Capacity-building and
greater investments are other interventions outlined in the National Transformation Program
2020. The strategy also includes the strengthening of the monitoring and evaluation of national
health plans, using a user-friendly set of indicators. The health system is largely funded through
the government budget, which is mainly financed by oil revenues. However, due to the drop in oil
revenues, there is a risk that the decrease in national revenues will adversely affect national
expenditure on health. Identifying alternative sources of funding such as cost -sharing and
premium payments or implementation of health insurance is therefore advised. In addition, the
private sector needs to introduce some sort of social insurance.
The Ministry of Health provides primary health care services through a network of health care
centres, hospitals and primary health care facilities. The network of health infrastructure has
improved the access of populations in remote areas to health services and a referral system
provides curative care for all members of society from the level of general practitioners and family
physicians at centres to advanced specialist curative services in general and specialist hospitals.
New national policies and strategies for primary health care have been developed that are patient
centred and fo.
The document discusses health surveillance and informatics. It defines surveillance as the systematic collection and analysis of health data for decision making. The purposes of surveillance include monitoring disease trends, evaluating programs, and informing policy. Health informatics involves the management and analysis of health information and can include fields like nursing informatics, clinical informatics, and public health informatics. Sources of health data include censuses, vital statistics, disease notification systems, health surveys, and hospital records.
Health policy plan. 2007-lönnroth-156-66Reaksmey Pe
This study assessed the impact of a social franchise model for tuberculosis (TB) care delivered through private general practitioners (GPs) in Myanmar. The key findings were:
1) The franchisees contributed around 20% of newly diagnosed smear-positive TB cases notified to the national TB program, helping to improve case detection.
2) Lower socioeconomic groups represented 68% of TB patients accessing care through the franchise, indicating it helped reach the poor.
3) The treatment success rate for new smear-positive cases through the franchise was 84%, close to the WHO target of 85% and similar to the national program rate.
4) While overall costs of TB care were high for poor patients, comprising on
Simple and Safe Approaches Towards Patient SafetyEhi Iden
A conference presentation on simple approaches and steps in achieving and managing patient safety in health. It talks about team approach, mutual support, just system, leadership commitment, complications of blame game and case study of the popular Kimberly Hiatt story.
Professor Benedetta Allegranzi,World Health Organisation
Dr. Benedetta Allegranzi is a specialist in infectious diseases, tropical medicine, infection prevention and control and hospital epidemiology. She currently works at the World Health Organization HQ (Service Delivery and Safety department), leading the "Clean Care is Safer Care" programme. Since 2013, Dr Allegranzi has gathered the title of professor of infectious diseases in the official Italian professorship list and is adjunct professor attached to the Institute of Global Health at the Faculty of Medicine, University of Geneva, Switzerland. She closely collaborates with the team at the IPC and WHO Collaborating Center on Patient Safety, University of Geneva Hospitals (Geneva, Switzerland), as well as with the Armstrong Institute for Patient Safety and Quality, John Hopkins University, (Baltimore, USA) for clinical research projects. She is currently involved in the leadership on the WHO Ebola Response in the field of IPC and supervises IPC activities in Sierra Leone and Guinea. She has experience in clinical management of infectious diseases and tropical medicine, and clinical research in healthcare settings in both developing and developed countries. She has thorough skills and experience in training and education.
She is also the author or coauthor of more than 150 scientific publications, including articles published in high-profile medical journal such as the Lancet, Lancet Infectious Diseases, New England Journal of Medicine and the WHO Bulletin, and six book chapters.
Δείκτης Ποιότητας και Διαθεσιμότητας της Ιατροφαρμακευτικής Περίθαλψης (Healt...Δρ. Γιώργος K. Κασάπης
Η ποιότητα και διαθεσιμότητα της ιατροφαρμακευτικής περίθαλψης έχει βελτιωθεί στις περισσότερες χώρες του κόσμου μετά το 1990. Όμως, από την άλλη, έχουν αυξηθεί οι ανισότητες τόσο μεταξύ των χωρών, όσο και στο εσωτερικό τους. Η Ελλάδα βρίσκεται στην 20ή θέση της παγκόσμιας κατάταξης, ακριβώς πάνω από τη Γερμανία, σύμφωνα με διεθνή μελέτη που δημοσιεύθηκε στο επιστημονικό έντυπο The Lancet.
Ερευνητές, με επικεφαλής τον καθηγητή Κρίστοφερ Μάρεϊ του Ινστιτούτου Μετρήσεων και Αξιολόγησης της Υγείας του Πανεπιστημίου της Ουάσιγκτον στο Σιάτλ, δημιούργησαν ένα νέο παγκόσμιο δείκτη (Healthcare Access and Quality Index), και βαθμολόγησαν από το 0 έως το 100, 195 χώρες ανάλογα με την ποιότητα της ιατροφαρμακευτικής περίθαλψής τους και του βαθμού στον οποίο έχει ο πληθυσμός έχει πρόσβαση σε αυτήν.
Ο δείκτης έλαβε υπόψη στοιχεία της περιόδου 1990-2015 και βασίστηκε στη θνησιμότητα που υπάρχει σε κάθε χώρα για 32 παθήσεις, η οποία θα μπορούσε να είχε αποφευχθεί με την κατάλληλη ιατρική φροντίδα.
Ουσιαστικά, ο δείκτης αξιολογεί το σύστημα υγείας κάθε χώρας ανάλογα με το βαθμό που οι κάτοικοί της πεθαίνουν με ρυθμό ταχύτερο του αναμενομένου από αιτίες που θα μπορούσαν να είχαν αποφευχθεί με την κατάλληλη ιατροφαρμακευτική παρέμβαση.
The document discusses setting core indicators for measuring AIDS accountability and progress in African Union Member States from 2015 onwards. It proposes four key indicators: 1) HIV incidence, 2) access to treatment, 3) stigma and discrimination, and 4) HIV testing. Additional cross-cutting indicators on intimate partner violence, financial accountability for health, and governance and public accountability are also recommended. The document provides the rationale and proposed data sources for each indicator. It concludes with a brief overview of monitoring and evaluation frameworks for HIV/AIDS programs.
The document discusses the healthcare industry and provides context for analyzing delays in patient discharge processes at a hospital from May to July 2015. It describes the objectives of studying delays, the sample size, tools used, and limitations. It then provides an overview of the global healthcare industry, key segments including hospitals, providers and professionals, models for healthcare delivery, and the market size of the industry in different regions. Porter's five forces model is applied to analyze competition in the healthcare industry.
Improving Efficiency to Achieve Health System Goals in Botswana: Background P...HFG Project
Health outcomes have improved in Botswana over the last few decades. These successes have come at the same time as overall macroeconomic growth, with annual Gross Domestic Product (GDP) growth averaging around 6 percent between 2010 and 2015 (IMF 2015), and Human Development Index ranking above the regional average. These improvements originate in a strong health service delivery system. In 2008, Botswana’s public health system included 338 health posts and 277 health clinics, sufficient to ensure that at least 80 percent of the population has coverage of essential, high-impact services. Management of these services was initially done by the Ministry of Local Government but has been transferred to district health teams under the Ministry of Health (MOH). As of 2008, Botswana’s public health system also had 17 primary hospitals, 14 district hospitals, two referral hospitals, and one mental health hospital; these hospitals are managed by the central government.
The document summarizes HIV/AIDS in Ethiopia across multiple topics:
1) HIV incidence in adults is estimated at 0.06% annually, corresponding to around 7,000 new cases, though a lower estimate is 0.05% or 6,000 new cases using a different method. Incidence is highest in those aged 50-64.
2) Ethiopia has made progress toward global 90-90-90 targets, with an estimated 82% of people with HIV knowing their status, 74% on antiretroviral treatment, and 66% virally suppressed.
3) Key populations include female sex workers, prisoners, divorced/widowed urban women, and long-distance drivers.
Presented at “Financial Protection and Improved Access to Health Care: Peer-to-Peer Learning Workshop Finding Solutions to Common Challenges” in Accra, Ghana, February 2016. To learn more, visit: https://www.hfgproject.org/ghana-uhc-workshop
This report provides the first global assessment of progress toward universal health coverage. It finds that while access to essential health services has increased globally, significant gaps remain. Coverage of key services like antiretroviral therapy and tuberculosis treatment is below 80%, and inequities exist both between and within countries. The report establishes a core set of tracer indicators to monitor coverage of reproductive, maternal, child, and infectious disease services. It highlights both successes in expanding coverage and the ongoing need to address remaining gaps to achieve universal access to quality health care.
Hiv &ictc seminar by Dr. Mousumi Sarkarmrikara185
India's national adult HIV prevalence is estimated at 0.26%. The total number of people living with HIV in India is estimated to be 21.17 lakhs. India has one of the world's largest HIV surveillance systems which helps monitor trends, levels, and burden of HIV among different populations. This system includes sentinel surveillance at antenatal clinics, Integrated Biological and Behavioural Surveillance among high-risk groups, sexually transmitted infection surveillance, AIDS case reporting, and death registration. The surveillance data is used to estimate disease distribution, identify groups for intervention, evaluate program effectiveness, and guide prevention efforts.
Swot analysis of Safe motherhood, HIV & AIDS, ARI and Logistic Management Pro...Mohammad Aslam Shaiekh
The Acute Respiratory Tract Infection (ARI) program in Nepal aims to reduce childhood mortality from pneumonia through early diagnosis and treatment. The program trains female community health volunteers to diagnose pneumonia in children under 5 using an ARI timer and treat cases with antibiotics. It also educates mothers on the differences between cough/cold and pneumonia and the need for referral. While the program has increased access to care, analysis found low coverage of treatment at health facilities and by community health workers, suggesting the need for improved case management and coordination between levels of care.
Socio-demographic Characteristics of Clients Visiting Integrated Counseling and Testing Centre (ICTC) at SMS Medical College, Jaipur (Rajasthan) India-Human immunodeficiency virus (HIV) infection is a global pandemic and India counts for 10% of the global HIV burden and 65% of that in the South and South-East Asia. This study of clients of ICTC was carried out to know the association of HIV positivity with socio-demographic variables. Total 2412 clients have visited at ICTC of SMS Medical College, Jaipur, either voluntarily or referred by various department of this institute in ICTC in 1st quarter of 2009. They Overall HIV positivity was found 12.35% with a significant difference in voluntary and referred clients i.e. 83.59% v/s 8.36%. It was also found that HIV positivity is more in reproductive age group than extremes of ages, more in females than males, more in person who were married but presently single because of separation of spouse, divorce form spouse or death of spouse than the unmarried or married living with their spouses.
Measuring performance on the Healthcare Access and
Quality Index for 195 countries and territories and selected
subnational locations: a systematic analysis from the Global
Burden of Disease Study 2016
Strategy Report on NHS and Recommendations - Gaspare MuraGaspare Mura
The document discusses challenges facing the UK National Health Service (NHS) including an aging population, rising life expectancy, and budget constraints. It analyzes the NHS using PEST and SWOT frameworks to understand external factors and identify issues. Key problems identified are lack of integration between primary, secondary, and community care services; insufficient capacity as demand increases; and need for continued development and innovation. Solutions proposed include optimizing resource allocation, improving preventative care and disease management, strengthening community services, and utilizing low-cost technologies.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Chandrima Spa Ajman is one of the leading Massage Center in Ajman, which is open 24 hours exclusively for men. Being one of the most affordable Spa in Ajman, we offer Body to Body massage, Kerala Massage, Malayali Massage, Indian Massage, Pakistani Massage Russian massage, Thai massage, Swedish massage, Hot Stone Massage, Deep Tissue Massage, and many more. Indulge in the ultimate massage experience and book your appointment today. We are confident that you will leave our Massage spa feeling refreshed, rejuvenated, and ready to take on the world.
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Gemma Wean- Nutritional solution for Artemiasmuskaan0008
GEMMA Wean is a high end larval co-feeding and weaning diet aimed at Artemia optimisation and is fortified with a high level of proteins and phospholipids. GEMMA Wean provides the early weaned juveniles with dedicated fish nutrition and is an ideal follow on from GEMMA Micro or Artemia.
GEMMA Wean has an optimised nutritional balance and physical quality so that it flows more freely and spreads readily on the water surface. The balance of phospholipid classes to- gether with the production technology based on a low temperature extrusion process improve the physical aspect of the pellets while still retaining the high phospholipid content.
GEMMA Wean is available in 0.1mm, 0.2mm and 0.3mm. There is also a 0.5mm micro-pellet, GEMMA Wean Diamond, which covers the early nursery stage from post-weaning to pre-growing.
INFECTION OF THE BRAIN -ENCEPHALITIS ( PPT)blessyjannu21
Neurological system includes brain and spinal cord. It plays an important role in functioning of our body. Encephalitis is the inflammation of the brain. Causes include viral infections, infections from insect bites or an autoimmune reaction that affects the brain. It can be life-threatening or cause long-term complications. Treatment varies, but most people require hospitalization so they can receive intensive treatment, including life support.
Feeding plate for a newborn with Cleft Palate.pptxSatvikaPrasad
A feeding plate is a prosthetic device used for newborns with a cleft palate to assist in feeding and improve nutrition intake. From a prosthodontic perspective, this plate acts as a barrier between the oral and nasal cavities, facilitating effective sucking and swallowing by providing a more normal anatomical structure. It helps to prevent milk from entering the nasal passage, thereby reducing the risk of aspiration and enhancing the infant's ability to feed efficiently. The feeding plate also aids in the development of the oral muscles and can contribute to better growth and weight gain. Its custom fabrication and proper fitting by a prosthodontist are crucial for ensuring comfort and functionality, as well as for minimizing potential complications. Early intervention with a feeding plate can significantly improve the quality of life for both the infant and the parents.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
Letter to MREC - application to conduct studyAzreen Aj
Application to conduct study on research title 'Awareness and knowledge of oral cancer and precancer among dental outpatient in Klinik Pergigian Merlimau, Melaka'
Hypertension and it's role of physiotherapy in it.Vishal kr Thakur
This particular slides consist of- what is hypertension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is summary of hypertension -
Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
Healthy Eating Habits:
Understanding Nutrition Labels: Teaches how to read and interpret food labels, focusing on serving sizes, calorie intake, and nutrients to limit or include.
Tips for Healthy Eating: Offers practical advice such as incorporating a variety of foods, practicing moderation, staying hydrated, and eating mindfully.
Benefits of Regular Exercise:
Physical Benefits: Discusses how exercise aids in weight management, muscle and bone health, cardiovascular health, and flexibility.
Mental Benefits: Explains the psychological advantages, including stress reduction, improved mood, and better sleep.
Tips for Staying Active:
Encourages consistency, variety in exercises, setting realistic goals, and finding enjoyable activities to maintain motivation.
Maintaining a Balanced Lifestyle:
Integrating Nutrition and Exercise: Suggests meal planning and incorporating physical activity into daily routines.
Monitoring Progress: Recommends tracking food intake and exercise, regular health check-ups, and provides tips for achieving balance, such as getting sufficient sleep, managing stress, and staying socially active.
10. WHOは何をしているのか
• Production of global public goods
• 国際基準・ガイドラインの作成
• Management of externalities across countries
• 国際保健規則の順守しているか査察・監視
• Mobilization of global solidarity
• 技術⽀援・資⾦供与
• Stewardship
• 決議・条約の制定
11
N Engl J Med 2013; 368:936-942. DOI: 10.1056/NEJMra1109339
2019/12/27
14. UHCキューブ
15
funds.Waitingtimesforservicesmayvarygreatlyfromonecountrytoano
some expensive services might not be provided and citizens may contri
a different proportion of the cos
the form of direct payments.
Nevertheless, everyone
these countries has access to
of services (prevention, promo
treatment and rehabilitation)
nearly everyone is protected f
severe financial risks thank
prepayment and pooling of fu
Thefundamentalsarethesame
if the specifics differ, shaped by
expectations of the population
the health providers, the poli
environment and the availab
of funds.
Countries will travel diffe
paths towards universal cover
depending on where and how
start, and make different cho
along the three axes outline
Fig. 1.2. For example, in sett
Fig.1.2. Three dimensions to consider when moving towards universal
coverage
Direct costs:
proportion
of the costs
covered
Population: who is covered?
Include
other
services
Extend to
non-covered
Reduce
cost sharing
and fees
Current pooled funds
Services:
which services
are covered?
Source: the World health report:
health systems financing: the path
to universal coverage (p. 12), by
World Health Organization, 2010,
Geneva: WHO Press.
3つのcoverageで評価
• Population coverage
• Service coverage
• Financial coverage
2019/12/27
15. 国⺠皆保険は必ずしもUHCではない
16
funds.Waitingtimesforservicesmayvarygreatlyfromonecountrytoano
some expensive services might not be provided and citizens may contri
a different proportion of the cos
the form of direct payments.
Nevertheless, everyone
these countries has access to a
of services (prevention, promot
treatment and rehabilitation)
nearly everyone is protected f
severe financial risks thank
prepayment and pooling of fu
Thefundamentalsarethesamee
if the specifics differ, shaped by
expectations of the population
the health providers, the poli
environment and the availab
of funds.
Countries will travel diffe
paths towards universal cover
depending on where and how
start, and make different cho
along the three axes outlined
Fig. 1.2. For example, in sett
Fig.1.2. Three dimensions to consider when moving towards universal
coverage
Direct costs:
proportion
of the costs
covered
Population: who is covered?
Include
other
services
Extend to
non-covered
Reduce
cost sharing
and fees
Current pooled funds
Services:
which services
are covered?
1958年の国保法改正により
⼈⼝カバー率がほぼ100%なった
1961年の国保の⾃⼰負担割合は
5割。⾼額療養費制度は未導⼊
2019/12/27
16. 保健システム強化を怠ると既存リソースの奪い合
いになる
17
for this improved reporting over time, comparison of services across years are adjusted for the population providing data by district and year.
The HMIS annual district forms available for 2005/2006 and 2006/2007 were not consistently available with 23 and 24 forms available, respectively, of a pos-
sible 56 original districts. Due to the low proportion of data available from these first 2 years of the study for this HMIS 128 form they were not included in this
table, regression modelling or graphs.
a
Linear regression slope of change in outcome rate per year.
b
Reports obtained as a percent of the total possible.
Table 5 IRRs and 95% CIs of the medium and high tertiles of patients on ART relative to the lowest ART tertile on district non-HIV care out-
puts, from district monthly routine HMIS data reports (2005/2006–2010/2011, 6 years)
Non-HIV care
output indicator
Medium investment in relation to low
investment IRR (95% CI, P-value)
High investment in relation to low
investment IRR (95% CI, P-value)
Number of
monthly
reports
with data
Denominator variable
for rates (model
exposure)
Outpatient visits for
children aged 4 and
younger
0.93 (0.90–0.96, <0.001) 0.89 (0.85–0.94, <0.001) 3419 Population
In-facility deliveries 0.96 (0.93–0.99, 0.020) 0.95 (0.91–1.00, 0.033) 3425 Population
DPT3 for children
younger than 1 year
of age
1.00 (0.96–1.03, 0.778) 0.94 (0.90–0.99, 0.017) 3419 Deliveries
TB tests 0.88 (0.83–0.94, <0.001) 0.78 (0.72–0.85, <0.001) 3369 Population
Malaria blood smears
conducted
0.99 (0.94–1.03, 0.519) 1.01 (0.94–1.07, 0.835) 3430 Population
Maternal deaths 0.93 (0.81–1.06, 0.292) 0.87 (0.73–1.04, 0.134) 3357 Deliveries
Source of data and notes: Uganda HMIS monthly data from Districts (based on the UgHMIS123 form), as collected by the research teams from each of
Uganda’s 112 districts. Control variables in the models include sanitation at the district level (% of population with pit latrines), % of eligible children enrolled in
elementary schools at the district level and HIV prevalence at the 10-region level. Additional control variables include year and month of source data, to control
for seasonal variation and a variety of annual factors. The unit of analysis is ‘District Month’. IRRs can be interpreted as the relative rate of the outcome measure
in relation to the lowest investment PEPFAR tertile when all other variables are held constant (i.e. considering the number of people on PEPFAR-supported ART
Health Policy and Planning, 31, 2016, 897–909. doi: 10.1093/heapol/czw009
2019/12/27
20. UHCサービス・カバレッジ・インデックス(SCI)
21
(2), and the Sustainable Development Goal aim
of achieving UHC for all by 2030 (3).
Monitoring UHC progress in the SDG era:
the service coverage index
The UHC SCI, which is the official measure
for SDG indicator 3.8.1 (4), was developed
14 indicators are not meant as a complete or
exhaustive list of health services and inter-
ventions covered in a given country’s UHC
programmes, nor do they measure the health
impact of these services. But they do pro-
vide a strong signal on the coverage of health
services needed by most populations across
sociodemographic settings.
Individual indicators have been proposed
as alternative intervention measures for the
UHC SCI (1,6), such as coverage of measles-
containing vaccine and second doses diph-
theria, tetanus, pertussis, rather than three
doses (DTP3). But in testing the effects of
substituting for alternatives five UHC SCI indi-
cators (Annex A1.1), the overarching results
do not vary from the approved 14 indicator
methodology (8).
Calculated for 183 Member States (Annex
A1.1), the UHC SCI is presented on a scale
of 0 to 100, since service coverage is typi-
cally measured on a scale of 0 to 100%, with
higher scores indicating better performance.
So, nearing or reaching 100 on the index can
be interpreted as meeting the SDG target.
Geometric means are used rather than arith-
metic means as they favour equal coverage
across services as opposed to higher cover-
age for some services at the expense of oth-
ers. Because the index is based on geometric
means and involves scaling non-intervention
coverage tracer indicators, reported values
do not directly translate to the percentage of
the population covered by UHC services (see
Annex A1.2 for more detail). But they can be
viewed as performance scores.
FIGURE 1.1 The UHC service coverage index (SCI): summary of
tracer indicators and computation
Reproductive, maternal, newborn and child health
1. Family planning (FP)
2. Antenatal care, 4+ visits (ANC)
3. Child immunization (DTP3)
4. Careseeking for suspected pneumonia
(Pneumonia)
Infectious disease control
1. TB effective treatment (TB)
2. HIV treatment (ART)
3. Insecticide-treated nets (ITN)
4. At least basic sanitation (WASH)
Noncommunicable diseases
1. Normal blood pressure (BP)
2. Mean fasting plasma glucose (FPG)
3. Tobacco nonsmoking (Tobacco)
Service capacity and access
1. Hospital bed density (Hospital)
2. Health worker density (HWD)
3. IHR core capacity index (IHR)
RMNCH = (FP · ANC · DTP3 · Pneumonia)1⁄4
Infectious = (ART · TB · WASH · ITN)1⁄4
if high malaria risk
Infectious = (ART · TB · WASH)1⁄3
if low malaria risk
NCD = (BP · FPG · Tobacco)1⁄3
Capacity = (Hospital · HWD · IHR)1⁄3
UHC service coverage index = (RMNCH · Infectious · NCD · Capacity)1⁄4
Note: For more detail on UHC SCI calculation methods, see Annex A1.2.
Source: Primary Health Care on the Road to Universal Health Coverage: 2019 Global Monitoring Report. WHO
• 16つあったUHC追跡指標のうち、データが
⼊⼿可能な14つを幾何平均したもの
• NCDに関しては、追跡指標の妥当性に検討
の余地あり
2019/12/27
21. ⾼所得国になるほどUHC SCIは⾼い
22
and the European (77) and Western Pacific
Regions (77). Even so, regional averages can
conceal inequalities, with some regions with
relatively high overall scores still having
some countries with low values (Figure 1.4).
All World Bank income groups also demon-
strated improvements on the UHC SCI since
2000 (Figure 1.3b). High-income countries had
Trends across UHC service coverage
domains
Globally, the infectious disease component
of the UHC SCI improved the fastest, with a
pronounced acceleration around 2005 (Fig-
ure 1.5). Among the indicators in the UHC
SCI infectious disease component, faster
FIGURE 1.4 Country-level UHC SCI values in 2017 varied – often substantially – within WHO regions
UHC SCI, 2017
70–7980 or more 60–69 50–59 40–49 Less than 40 Data not available Not applicable
Note: This map has been produced by the World Health Organization (WHO). The boundaries, colours or other designations or denominations used in this map
and the publication do not imply, on the part of the World Bank or WHO, any opinion or judgement on the legal status of any country, territory, city or area or of its
authorities, or any endorsement or acceptance of such boundaries or frontiers.
2019/12/27
22. UHC SCIは世界全体で改善傾向あり
23
14 • Monitoring population coverage with health services: SDG 3.8.1
FIGURE 1.3 The UHC SCI improved from 2000 to 2017 in all WHO regions and World Bank income groups
Value of UHC SCI Value of UHC SCI
0
20
40
60
80
100
20172015201020052000
Region of the AmericasEuropean Region
Western Pacific Region
World
Eastern Mediterranean Region
South-East Asia Region
African Region
0
20
40
60
80
100
20172015201020052000
World
Low income
Lower middle income
Upper middle income
High income
2019/12/27
24. 破滅的なOOPSは特に中所得国でみられる
25
Global Monitoring Report on Financial Protection in Health 2019 • 13
FIGURE 2 There are large variations within regions in the percentage of people with catastrophic health
spending, as tracked by Sustainable Development Goal indicator 3.8.2
Percentage of the population with out-of-pocket health spending exceeding 10% or 25% of the household budget, most recent year available
10% threshold 25% threshold
3.28–6.690.20–3.28 6.69–12.59 12.59–54.20
Data not available Not applicable
0.44–1.090.01–0.44 1.09–2.53 2.53–22.16
Data not available Not applicable
Note: These maps have been produced by the World Health Organization (WHO). The boundaries, colours or other designations or denominations used in this
map and the publication do not imply, on the part of WHO or the World Bank, any opinion or judgement on the legal status of any country, territory, city or area or
of its authorities, or any endorsement or acceptance of such boundaries or frontiers.
Source: Global database on financial protection assembled by WHO and the World Bank, 2019 update.
Source: Global Monitoring Report on Financial Protection in Health 2019. WHO & WBG2019/12/27
25. 世界全体として保健医療サービスの利⽤による破
滅的なOOPSを被っている家計は増えてる
26
hold budget increased from 1.7% to 2.9% (Fig-
ure 2.3).
All WHO regions saw increases in the num-
ber of people and percentage of population
with catastrophic health spending between
2000 and 2015 (Figure 2.4). The highest
and the Western Pacific Region.6
In the South-East Asia Region and the Euro-
pean Region, the rate of increase between
2010 and 2015 in the number of people and
percentage of the population with catastrophic
health spending as tracked by SDG indicator
3.8.2 was worse than that between 2005 and
2010.7
In the African Region and the Western
Pacific Region, there was a marginal decline
in the percentage of the population with cat-
astrophic health spending between 2010 and
2015 but not in the number of people.8
The
Region of the Americas was the only region
where the number of people and percentage
of the population with catastrophic health
spending at both thresholds fell between 2010
and 2015 (Annex 2.1).9
High-income countries had the lowest
number and percentage of people with cat-
astrophic health spending exceeding both
thresholds of the SDG indicator 3.8.2 in 2000.
But between 2000 and 2015, they experienced
a steady increase in the number of people and
percentage of the population spending more
than 10% or 25% of the household budget on
health out of pocket10
(Figure 2.5).
Low-income countries had the highest
number and percentage of people with out-of-
pocket health spending exceeding the 10% and
25% thresholds in 2000,11
but after an initial
FIGURE 2.3 Globally, financial protection against
out-of-pocket health spending decreased
continuously between 2000 and 2015, as tracked by
Sustainable Development Goal indicator 3.8.2
Percentage of the population with out-of-pocket health spending
exceeding 10% or 25% of the household budget
10% threshold 25% threshold
0
5
10
15
2015201020052000
Source: Global monitoring report on financial protection in health 2019 (4).
• 所得が増えれば保健医療サービスへの需要
が⾼まり、主に⺠間による⾼度・⾼額な医
療サービスの提供も増える
• しかし国の保健財政制度の整備が追いつか
ないことが多い
Source: Global Monitoring Report on Financial Protection in Health 2019. WHO & WBG2019/12/27
26. もっと勉強したい⽅へ
27
Tracking universal health coverage:
2017 Global Monitoring Report
Primary Health Care on the Road
to Universal Health Coverage
Global Monitoring Report on
Financial Protection in Heath 2019
2019/12/27
29. グローバルヘルス業界においてエントリー・レベ
ルの求⼈は1割未満しかない
30
RESEARCH ARTICLE Open Access
Mapping the global health employment
market: an analysis of global health jobs
Jessica M. Keralis1*
, Brianne L. Riggin-Pathak2
, Theresa Majeski3
, Bogdan A. Pathak2
, Janine Foggia3
,
Kathleen M. Cullinen4
, Abbhirami Rajagopal3
and Heidi S. West5
Abstract
Background: The number of university global health training programs has grown in recent years. However, there
is little research on the needs of the global health profession. We therefore set out to characterize the global health
employment market by analyzing global health job vacancies.
Keralis et al. BMC Public Health (2018) 18:293
https://doi.org/10.1186/s12889-018-5195-1
2019/12/27