Health Care Infrastructure
description
Transcript of Health Care Infrastructure
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East Africa
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• Practitioners• Divination (diagnose via material devices or inspiration)• Spirit Mediums – exorcise or integrate spirits, or propitiate• Rainmakers (or rain controllers)• Herbalists• Midwives
• Medicine• curative treatment• restore and protect• some things activate medicines, e.g. v. sorcery
• Incorporated innovations• Swahili – mganga; Luganda - omusawo
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• Historical legacies• Environment• Local, social, cultural
• Political landscape• Regional and International connections
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• Historical legacies• Missionaries• Colonialism• Doctors 2nd largest group recruited into British Colonial
Service after Admin Officers (Crozier, 2007)
• Alternative to being Missionary; Empire; Adventure• New discipline of “Tropical Medicine”
• Focus of work• Diseases• Prevention
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• Historical legacies• South Asian sub-assistants• Training of African Health Care providers (see Iliffe, 1998)
• Missionary trained ‘semi’ - professionals• African Native Medical Corps (WWI)• “Tribal” dressers – rural areas
• Disease campaigns• E.g. versus Yaws , (1920s – 1930s)
• Mengo University ….Makerere University• Mulago Medical School – clinical emphasis, est. 1927
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• Human Resources – Work force• Not just doctors and nurses• Who staffs…?• Pharmacies• Labs• Training facilities• Administrative and finance• Record keeping• administration
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• Physical – facilities• Institutional mix• Cultural expectations• Legal Framework• Licensing, malpractice, insurance
• Providers• Public• Private (…for profit)• Voluntary (…non-profit)
• Type of approach
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• Approaches • Allopathic/ conventional/ ‘modern’ /western• Complementary, Alternative and biosocial• ‘traditional’ / indigenous• Western alternatives – osteopathic, homeopathic,
chiropractic, etc• Eastern alternatives – Chinese, Ayurvedic, etc
• Influence of latest donor concern / trend / fad … e.g…• Decentralization and community decision making• Monitoring and Evaluation• Integration
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• Surgical work force• Attrition of work force• Cost of migration• Central control and standards (including safety)
• Local knowledge of local needs• Role of local politics and patronage• Technocrats versus politicians
• Complex mix of agencies involved in hiring (Tanzania)
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• Administrative theory• You stand where you sit…• Recruitment and socialization within organization
• Organizational goals (health care philosophy)• Efficiency, effectiveness, equity• Accountability, Standards
• Decentralization• Deconcentration• Delegation• Devolution• Privatization
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• USAID funded Health Systems 20/20• Health Systems 20/20 (2006-2012), funded by the United
States Agency for International Development, is the Bureau of Global Health’s principal project for health system strengthening.• http://www.healthsystems2020.org/• Useful collection of resources… sample
• CSIS Global Health Policy Center• The Global Health Policy Center is a leading policy research
institution focused on building bipartisan awareness about global health and its importance to U.S. national security.Including the Forum on Advancing U.S. Leadership in Global Health• http://www.smartglobalhealth.org/
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• Global Health Europe• promotes synergy between the policy spheres of public
health, foreign policy, development, and research for health. Not-for-profit, non-partisan platform and think tank. • http://www.globalhealtheurope.org/
• Global Health Security Initiative (GHSI) • informal, international partnership among like-minded
countries to strengthen health preparedness and response globally to threats of biological, chemical, radio-nuclear terrorism (CBRN) and pandemic influenza. • http://www.ghsi.ca