Promoting Health Globally: Quiz 1

"health is not only the absence of infirmity and disease but also a state of physical, mental, and social well-being"

transcend international borders, factors influence from different countries, cooperative actions and solutions

developed as a discipline in the 19th century in UK, Europe, and US concerned more with national issues

developed during the past few decades came to be more concerned with diseases, conditions; one way flow of good ideas

1978 in Kazakhstan convened by WHO and UNICEF with the end goal being health for all by 2000; 134 countries, 67 international orgs

essential health care, at a cost that the community and country can afford, integral part both of the country's health system; first level of contact of individuals, the family, and community with the national health system

(Health for All) grassroots health movement, principles of primary health care to form "People's Health Assembly" which 1453 participants from 92 countries

Bubonic Plague, quarantine created, cordon sanitaire barrier

Industrial revolution, imperial conquests leading to colonization, rise of modern public health (health office of League of Nations)

League of Nations (1920), Bretton Woods Agreement (1944)

established International Monetary Fund (IMF) and International Bank for Reconstruction and Development (IBRD)

established World Health Organization (1948), established International Cooperation Agency (1955) as the first coordinating agency for foreign aid

vertical health programs, supply driven

have three components: intervention strategy, monitoring and evaluation, and intervention delivery.

new approaches to international assistance, more partnerships

(big 3) reduce child mortality, improve maternal health, reduce rates of malaria, HIV, and other diseases

set of goals through 2030; characteristics of universality, integration, and transformation

"ensure healthy lives and promote well-being at all ages": focused target on HIV/AIDS epidemic; actively eliminating TB, malaria, and other tropical diseases by 2030

founded 1863

founded 1945

founded 1948

1977

2002

2005

technologies, systems design, institutions, leadership

PAHO, WPRO, AMRO, AFRO, SEARO, EURO

Dr. Margaret Chan, $4.4 billion budget

stewardship: the overall performance of a country's health system must always lie with the government

disseminates International Classification of Disease (ICD-X) codes; formulates & disseminates advice, standards, guidelines; Assists & organizes projects on specific problems and/or target groups per priorities set by World Health Assembly

limited institutional authority, weak functioning model, "soft power" institution, hard to evaluate accomplishments, donors have large amount of power, 1 country = 1 vote

UNAIDS, Global Fund, World Bank Group, World Trade Organization; IMF and IFC (international financial corporation) to rid of poverty

undermine role of national and state sovereignty, donors obtain power and dominate vote, corruption

refers to aid assistance provided by one government to another government: by using/taking resources offered, negatively effects finances of country

USAID, SIDA (Sweden), JICA (Japan), DFID (UK), CIDA (Canada)

Department of Health and Human Services, Dept. of Defense, Dept. of State

doesn't always follow economics because must use resources from donor country (not always cheapest), donor sets priorities, siphon off best host country health workers
with higher salaries

defined by extraordinary diversity: profit, non-profit, secular, religious, narrow programs, broad programs, long term commitments, short term commitments, etc.

charitable (doctors w/o borders), philanthropic (Bill and Melinda Gates Foundation), membership (APHA), consulting/contracting (John Snow)

low operational costs, less chance of corruption

May compete or not coordinate actions with similar NGO and country programs, NGO salaries can distort host country salary structure and compete for competent government personnel

1. communicable, maternal, perinatal, nutritional
2. non-communicable
3. injuries

determinants of health, measurement of health status, global burden of disease

1. coronary heart disease
2. stroke and cerebrovascular disease
3. lower respiratory infections
4. COPD
5. Diarrheal diseases
(physical inactivity becoming increasing issue)

Physical environment, health behaviors, individual, access to health services, social environment

Universal Health Care

1. governance for health and development
2. participation in policy-making and implementation
3. promoting health and reducing health inequities
4. global governance and collaboration
5. progress and increase accountability

Cause of death, Life expectancy at birth, Maternal mortality rate, Infant mortality rate, Neonatal mortality rate, Child mortality rate [Under-5 mortality]

per 100,000 live births

per 1,000 live births, under 1 yr old

per 1,000 live births, under 5 yrs old

premature death or state of less than full health

combines years of life lost due to premature mortality and years of life lost due to time lived in states of less than full health using the disability adjusted life year (DALY)

New epidemics of chronic illness are following in the wake of rapid urbanization and economic change, the epidemiological profile of many LMICs is becoming similar to that in developed nations, during the last two decades there has been a fundamental shift in global patterns of disease (chronic disease)

needs to be transnational and transinstitutional