HSC4624 W1&2 Q1

½ million fetuses are aborted for _____ ______

Female Feticide

Compare the health system in the US to other European countries.

US has a public/private hybrid system and Europe has a universal coverage for less money (Slide 23, 29 for Exam). Europeans also visit there physicians much more often than in the US, because wellness visits and primary care check ups are integral parts of health in Germany. Yet we spend the most money on health than these other nations.

What type of machines used by gynecologists have tight regulations imposed on them?

Ultrasound machines and made it illegal for a doctor to reveal the gender of a fetus. But that hasn't stopped the practice, and ultrasound clinics have sprouted up almost everywhere.

________ has the highest expenditure on Health Care

United States

Canada Health care system

Universal and comprehensive insurance system for hospital & medical care

What are parasite singles? How might they influence population growth?

Unmarried youth that live with their parents while pursuing careers and other interests besides marriage.

In India's capital, more than 3 million people live on less than

$2 a day

Population Size Influenced by 4 factors

- Births - Deaths - Immigration - Emigration

Describe 4 core components of PHC.

-Food supply & nutrition, -Maternal & child health, -Immunizations, -Prevention of diseases

Six building Blocks of a Health System

-Good Health Services -Well-performing Health Workforce -Well-functioning Health Information -Essential Medical Products -Good Health Financing -Leadership and Governance

Name 4 specific examples of why population growth has slowed. What factors affect population growth?

-Influenced by fertility rates (decline because parents choose to have smaller families), -Family planning services (educated woman produce healthier children and smaller families), -Increased mortality due to infectious diseases (especially HIV/AIDS), -Military conflicts

Describe the 5 problems that can occur in health delivery.

-Inverse care -Impoverishing care -Fragmented care -Unsafe care -Misdirected care

Name a few Public Health Activities

-Promotion of hand washing, -Promotion of wearing helmets, -Promotion of knowledge about HIV/AIDS, -Screening of diabetes and hypertension, -Screening and promotion of children health

8 Millennium Development Goals

1. Eradicate Extreme Hunger and Poverty 2. Achieve Universal Primary Education 3. Promote Gender Equality and Empower Women 4. Reduce Child Mortality 5. Improve Maternal Health 6. Combat HIV/AIDS, Malaria and other Diseases 7. Ensure Environmental Sustainability 8. Develop a Global Partnership for Development

Health systems have three levels of health care:

1. Primary- Seek care at a doctors office or local community health center. 2. Secondary- Care for surgery or complicated illness provided at general hospital or district hospital. 3. Tertiary- Provides highest level of care in hospitals which are located only in major cities.

What proportion of girls is being eliminated at the fetal stage?

1/5

The early childhood death rate was cut by ___________ with anti-malarial drugs and bed nets

2/3

What are the 4 functions & 3 outcomes of a health system?

4 functions the health system performs: -Stewardship (governance, who is in charge), -Resources, -Service delivery, -Financing. 3 Goals/Outcomes of the system: -Health (quality in distribution across the population), -Responsiveness (to people's expectations), -Financial protection (fairness in contribution).

VIDEO 5 India: The Missing Girls How many new Indians are born every day, leading to a population of 1.1 billion and counting?

41,000

________ (percent) tested positive for malaria and more than _______ of children died before the age of five.

60% malaria 15% died

How many Millennium Villages are there across Africa?

80 villages spread throughout ten different African countries.

The United States is also an aging society, but we are not facing the same issues as Japan. Explain the difference & why.

America's workforce continues to grow as a result of immigration.

Describe the East Asia demographic phenomena. How might this help India & Kenya?

As fertility fell, these governments took money once spent on children and created jobs for young adults entering the work force. If India and Kenya keep fertility down and invest in their young, working-age people, India and Kenya have an opportunity to escape the poverty traps that have ensnared them for centuries.

What is the infant mortality rate in the US?

Average is about 7 deaths per 1000 births, Which is the highest of the industrialized nations.

________ _________ profits have given the 194 women in the villages an income they can use to start other projects and help their families.

Basket-weaving cooperative

In 2006, what type of nets was a top priority?

Bed nets

What is brain drain? Why is there a global shortage of health workers?

Brain drain: Poor working conditions at home in the appeal of higher salaries abroad, drives thousands of health works from developing countries to jobs in wealthy countries each year, making these shortages worse.

What is the new focus of the Millennium Villages?

Business development. They've been hosting funders, some of them eager to support major business opportunities.

Replacement births

By having 2 children per a couple the population does not grow. It stabilizes the number of children replaces the parents. Small family sizes allow for parents to achieve a higher standard of living, affordable education, improved nutrition, and improved access to health care.

_____ ______ is now the leading cause of death worldwide

Cardiovascular disease

How is HIV/AIDS shaping Kenya's society? Economy?

Causing life expectancy to plummet from 65 to 49 years. AIDS and population growth have become tragically linked.

Why are missing girls linked to cultural beliefs?

Chinese population pyramid has slightly more males. Almost all age groups (except those over 64) have larger male than female population. Phenomenon is known as "missing girls." Especially of concern is the substantial "surplus" of males. Strong preference for male births in the Chinese and most other Asian societies.

_________ is needed to solve some global health problems.

Cooperation

VIDEOS 3 AND 4 World in the Balance: The People Paradox What has happened to fertility rates in Japan? What happens if fertility stays at current rate?

Declined to a low rate of 1.3 children per a woman, by the end of the century Japan's population of 126 million will shrink in half.

_______ and _________ is important to predict health challenges in a population.

Demographic & epidemiological transition

What is feticide about?

Dowries, the high price families must pay to marry off their daughters.

Population momentum

Even with less replacement births the population continues to grow because of the large number of woman at child baring age. Increases the absolute number of people even when women are having less children

What are the 6 elements of quality?

From the patient perspective the US healthcare performs relatively poorly (last in almost everything except effectiveness, compared to other countries). Six elements of quality: 1. Safe 2. Effective 3. Patient centered 4. Timely 5. Efficient 6. Equitable

How would they break the cycle of subsistence and starvation in this village?

Get the villagers to diversify their crops and to terrace their land to help spread irrigation in this bone-dry soil.

Describe the population pyramid shaped by HIV

Haunting shape, with large numbers of children at the base, disappearing adults in the middle, and the few surviving seniors on top.

Global Health

Health problems, issues, & concerns that transcend national boundaries and may best be addressed by cooperative actions.

The fight for health is a ________ _________.

Human Right

Social Solidarity

In developed high income countries. Health care is financed by individuals on the basis of their ability to pay, but should be available to all that need it on equal terms.

Week 1 Part 2 Intro to GH: Name 4 determinants that impact individual health

Individual (Genetic make-up, sex, Age), Physical Environment (Water, Sanitation, Air pollution), Health behaviors, Access to Health Services, Social Environment (economic status, Education, etc..)

What can impure water do to one's internal organs?

Irreparably shredded by bacteria

KEY CONCEPTS- Health, human development, labor productivity and economic development are

Linked

Describe Japan's population pyramid

Looks like India's turned upside down, reflecting how the elderly dramatically outnumber the young.

VIDEO Intro to Global Health: This I Believe What does poor mean?

Means to be bereft of rights

DALY (Disability Adjusted Life Year) -

Measure of premature deaths and losses due to illness and disabilities in a population

______ ______ ______ are reversing development disparities & improving health

Millennium Development Goals (MDG)

How many premature deaths occur each year?

Millions

Why do they continue aborting girls (in a country with no social security)?

More than anything, feticide is about dowries, the high price families must pay to marry off their daughters. Also, It is the son's duty to care for his ailing parents, and many parents feel that only a son can light their funeral pyres and carry on the name.

How much aid was provided in the last 40 years to the Millennium Villages?

More than half a trillion in aid has not made life better for most Africans.

Name a few Global Health Issues

Number of low birth weight babies born, high death rate in first month of life in babies, Measles in young children, Diarrhea and pneumonia in young children, TB, Malaria, HIV/AIDS, Parasitic infections, Rapid increase in diabetes and heart disease.

HALE (Health-Adjusted Life Expectancy) -

Number of years to be lived in the equivalent of good health

How many doctors in India have been convicted of performing female feticide as reported in early 2007?

Only one doctor in India has ever been convicted of performing female feticide.

1,000 seedlings of ___________ were sent to this village for agricultural development.

Pomegranate

What factors limit progress to meeting the MDG targets?

Resources are not distributed uniformly, such as: -Adequate food, potable water, housing, income, employment, education, and safety for all -Access to health care & medicines Chronic diseases vs. infectious diseases: -High income countries have increased #s of chronic disease (Cardiovascular disease, diabetes, obesity) -Low income countries extremely burdened with infectious disease (Malaria, HIV, TB, Dengue).

____ _____ are central to health and to addressing health concerns

Risk factors

Public Health

Science & art of preventing disease; prolonging life; & promoting physical & mental health through organized community efforts toward a sanitary environment, control of community infections, education in hygiene & development of social machinery in community to maintain health.

Week 1 Part 1 Intro to GH: Health

State of complete physical, mental, & social well-being and not merely the absence of disease or infirmity.

The growth of sorghum, maize, beans, and _____ ______ were used to improve agriculture.

Sweet Potatoes

Week 2 Global Health Systems Primary Health Care

The activities, entry point into the healthcare system, and the clinicians that provide these services in general medicine to treat illness or disability.

Life Expectancy at Birth

The average number of years a newborn baby could expect to live if current mortality trends were to continue for the rest of the newborn's life. Measure overall quality of life in a country!

Infant mortality Rate

The number of deaths of infants under age 1 per 1000 life births in a given year.

Under Five Mortality Rate (Child Mortality Rate)

The probability that a newborn baby will die before reaching age five, expressed as a number per 100 live births.

What is the ultimate goal of Partners in Health (as described for a utopian society)?

The refashioning of our world into one in which no one starves, drinks impure water, lives in fear of the powerful and violent, or dies ill and unattended.

Describe the 4 demographic transition stages

The transformation from high birth in death rates to low birth in death rate as part of the economic development of a country from a pre-industrial to an industrialized economy. -Stage 1: high mortality (death) & birth rates -Stage 2: decreased mortality rates, high birth rates (societal conditions improve) -Stage 3: birth rates decline & become close to mortality rates -Stage 4: mortality & birth rates oscillate in close proximity to each other (population in balance!)

What happened at the Alma Ata convention?

The world community came together to declare a new emphasis on health for both developed and developing countries. The declaration emphasized that primary care should focus on prevention of illness and not just the cure.

As a society ages, what concerns will need to be addressed?

There will soon not be enough young people entering the workforce to support those retiring.

How many immigrants would need to be taken in each year?

To keep its workforce from shrinking, an aging country like Japan would need to take in 600,000 immigrants a year.

In Africa, population growth is increasing despite high death rates from HIV/AIDS. Why & what impact will this have on other systems? Environment?

To meet rising demands for food, and shelter, the forests are disappearing at the fastest rate the world. As countries struggle to obtain a decent standard of living, natural environments are increasingly strained. The degradation not only threatens Africa's unique wildlife but creates hardships for people who live off the land.

KEY CONCEPTS: Primary care provides

basic health services to all

The poorest countries have a relatively larger burden from

communicable diseases than from non-communicable diseases

What does the NGO Datamation do in India?

counsels young women away from female feticide.

the public, private, and NGO systems have

different roles in different countries

There are enormous __________ in health.

disparities

Strengthening health systems is critical to improving

health outcomes and quality

Population growth, aging populations, sex ratio/son preference will influence

health outcomes in future

KEY CONCEPTS: A number of factors influence

health status

Countries can achieve high levels of health, even without

high levels of income.

An important part of health status depends on

individuals, families, and communities

In 1994, Rwandan genocide killed what proportion of people?

one in ten Rwandans

The main functions of a health system are to

raise money for health services, provide health services, pay for health services, and engage in governance and regulation of health activities.

The health of each of us is linked to

the health of all of us

Video 2 Millennium Villages: What is the goal of the Millennium Villages project?

to permanently improve life in a rural village within five years.

There has been great progress in Global Health in the last 50 years, but progress has been

uneven and large gaps remain

France Health care system

• Funded by tax revenues & social health insurance contributions from employers and employees • All legal residents covered by public health insurance

United Kingdom Health care system

• Largest publicly funded health service in world. • Primary care trusts

Germany Health care system

• Oldest universal program of health insurance (1883) • Sickness funds • Health system predominantly funded through social health insurance contributions

Public, Private and NGO Sectors

• Public Sector: national, state, or municipal level • Private Sector: for-profit and not-for-profit • Nongovernmental Organizations (NGOS): large or small, local,national, or international