health system
TRANSCRIPT
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Comparison of Health System in developed and developing countries
Dr Arvind Dhiman JR-3
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1.Health system. 2.Method to evaluate health systems. 3.Hurdels for poor health system in developing
countries. 4.Features of health system in Developed countries. 5.Recommendations
Lay out of this presentation
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Health System
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A health system, also sometimes referred to as health care system or healthcare system, is the organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations.
Health System
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Concepts-Health and Disease
Ideas- Equity, Coverage, effectiveness ,efficiency and impact.
Objects-Hospitals, Health Centers and health programs.
Persons-Providers and consumers
Components of Health System
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Evaluation of Health System
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Life Expectancy at Birth IMR Under 5 mortality Maternal Mortality Doctor Population Ratio Nurse population ratio GNI per capita Per capita public expenditure on Health Adult Literacy rate Access to safe water % population. Access to adequate sanitation percent population.
Indicators
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1 France 2 Italy 3 San Marino 4 Andorra 5 Malta 6 Singapore 7 Spain 8 Oman 9 Austria 10 Japan
112 India
Ranking as per Health System by WHO-2000
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Government of concerned country is responsible to provide better health care for people.
High quality health care -Partnerships among federal state, local governments and the private sector
Central role is to control costs, increase access and improve quality
Role of Government in health system
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Type of Political System
Developed Developing
Democracy USA India
Autocracy Cuba Vietnam
Monarchy JAPAN Bhutan
Socialistic Norway Poland
Oligarchy Saudi Arab South Africa
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Comparison of Developed and developing countries
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Country Life Expectancy at Birth
Per capita health expenditure
Access to Improved Water % population
Access to Sanitation %age population
USA 78.88 9146 US Dollar
100% 100%
CUBA 81 603 94 93JAPAN 86 3966 100 100POLAND 81 895 100 100SAUDI ARAB 77 808 97 100INDIA 68 61 93 36ETHOPIA 65 25 52 24BHUTAN 68 90 98 47TANZANIA 61 49 53 12SOUTH AFRICA
59 593 95 74
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Country IMR Doctor Population ratio
Deaths due to Diabetes per Lakh
USA 6/1000 live births 2.5/1000 15.2/100000
CUBA 5 6.7 14.2
JAPAN 2 2.3 4.5
POLAND 5 2.2 11.1
SAUDI ARAB 13 2.5 22
INDIA 41 0.7 23.8
ETHOPIA 44 0.1 62
BHUTAN 30 0.3 22.3
TANZANIA 38 0.2 53
SOUTH AFRICA 33 0.8 66.7
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Wide gap in health sector between Rural and Urban areas.
High out of pocket expenditure.
Claim free public health care but is insufficient.
Selective insurance cover in developing countries.
Hurdles in developing countries for better Health System
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Brain Drain (Experts go to developed countries to peruse their profession having good wages)
Popularity of Village doctors (Quakes).
Religious reasons – 30 FHW killed in Peshawar(Pak) and Bill for willful family planning in Iran.
Lack of Commitment at political,Adminstration and at Public level.
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Corruption-10% and 25% of global spend on public procurement of health is lost through corruption
Preventive care is at Early stages in developing world.
In developing countries, about 80% of illnesses are linked
to poor water and sanitation conditions.
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Non communicable Diseases in Developing Countries
Emerging As a Global Health Crisis
In 2013 alone, NCDs killed eight million people before their sixtieth birthdays in developing countries.
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Population growth . Fertility rate ranges from between three and seven children per
woman.
Sanitation –Out of I billion people in World who has no toilets, India account for 600 Million.
900 million smokers in Developing countries-Smoking cause fatal and disabling diseases.
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In 2010 2 million people died due to IHD
Lack of efficient Disaster preparedness. In Nepal earthquake- 9,000 people killed and 23,000 injured.
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Universal Health insurance Ex. Japan (life expectancy 86 and IMR 2/1000)
Focus on Preventive health care like Cuba.
Clinical research oriented Health System.USA is on the top in clinical research.
Features of Developed Countries
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Compulsory health checkup for immigrants
No Insurance in Italy, government covers most of their medical bills, and has low spending.
No Social differentiation in public and Private health facilities.
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Every body is covered automatically at birth.
Health coverage stays with person entire life in Canadian health system.
Technological breakthroughs have occurred in treating numerous diseases.
Strong awareness programs-Quit rate of Tobacco increased in US,UK and Brazil etc.
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Preparedness for disaster is better in developed world.
Japan and Chile minimized the loss of life and damage due to Earth quakes and Tsunami.
Sharp decline in fertility in the developed countries near 1.2 to 1.3.
In Europe Deaths may increase for birth by 2025.
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Robust financing mechanism.
Well trained and adequately paid workforce.
Reliable information in order to make decisions and policies.
Well maintained facilities and logistics to deliver medicine and technologies.
Strengthening the Health system in Developing countries.
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More spending is required on Primary care to: Enhance access to healthcare services
Better health outcomes
Decrease in hospitalization visits
Use of emergency department visits.
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Incentive to draw health care practitioners into rural services.
Public private partnership in Health sector.
Sanitation in Developing countries- Building lavatories but also changing habits
Promotion of Preventive Health – Preventable diseases and cost effective.
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Thank You
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1.Health care spending around the world[Internet].Accessed on 22/07/2015.Available from:http://www.theguardian.com/news/datablog/2012/jun/30/healthcare-spending-world-country.
2.National Health Mission[Internet].Accessed on 24/07/2014.Available from:http://nrhm.gov.in/nhm.html
3. WHO validates elimination of mother-to-child transmission of HIV and syphilis in Cuba[WHO validates elimination of mother-to-child transmission of HIV and syphilis in Cuba [Internet].Accessed on 21/07/2015.Available from http://www.who.int/mediacentre/news/releases/2015/mtct-hiv-cuba/en/
4.Oxford Text book of Public Health.5th Edition.
5.Maxy-Rosenau-LastPublic Health and Preventive Medicine.15 th Edition
6..Top 10 socialistic countries in world .Available from http://blog.peerform.com/top-ten-most-socialist-countries-in-the-world/ .Accessed on 23/07/2015.
7.World life expectancy.com
References