The Concept of Health Systems Strengthening - Assignment Example

Global Health/International Studies FINAL EXAM QUESTION Thesis ment. The aim of the question is to gain an understanding of the key elements underlying the Health Systems Strengthening that is required for developing the healthcare related aspects of people residing in fragile states. Furthermore, the question would discuss the existing difference amongst rebuilding services and systems. The concept of ‘Health Systems Strengthening’, relates to the development of an understanding of the factors associated with improving the health of people living in society and making sustainable changes in healthcare standards to develop the quality of the same. ‘Healthcare Systems strengthening’ is a mechanism launched by several nations and government bodies across the globe with the prime purpose of defending situations of ill-health as a result of issues such as poverty and malnutrition. In this context, it is worth mentioning that such organizations have devised a number of elements that play an important role in defending health-related issues and rebuilding health in fragile states. In the context of health related issues, the state as well as non state providers in the fragile states can be distinguished on the basis of both economic as well as political aspects. Furthermore, the contribution of both state as well as non state are different with respect to providing diverse health related service to fragile states. This in turn signifies existence of differences in terms of service delivery. The differences in service delivery can be further analyzed by considering the example of Afghanistan and Southern Sudan in the context of urbanization. Some of the factors that are likely to cause differences in service delivery between state and non state include political settlement as well as the instruments used to provide medical aid to the concerned people (Commins 597). In relation to the aforementioned statement, service delivery can be regarded as one of the most vital elements associated with fostering and rebuilding health in fragile states. Service delivery aims at improving healthcare facilities through concentrating on the development of the quality services for people located in fragile nations. Another important element associated with rebuilding of health are the national healthcare plans as well as strategies framed by the healthcare authorities towards ensuring successive growth and development of healthcare in fragile states (Ramin 886). Service delivery is an important element in the context of healthcare strengthening since it leads to the development of successive understanding of the factors associated with fostering healthcare in fragile states. In this context the factors of healthcare has resulted establishment heath centers, medical wards, departments and clinical campaigns that in turn positively influences the health of people residing in fragile states. Resource management is another important element in Health Systems Strengthening underlying the development of healthcare in fragile states. In association to the element of service delivery, resource management aims at boosting the healthcare services by way of providing healthcare facilities, training to medical staff, amongst others (Ramin 886). In fragile nations of Sub-Saharan Africa, wherein only 39.1% of the people belong to urban locations and the remaining resides in rural zones, a majority of the locations are covered by situations of chronic illness and prevalence of diseases. Addressing the healthcare needs of people and assessment of their urgencies in critical situations can be a core element in facilitating healthcare services across the nation. Moreover, there is a need to gather pertinent information underlying health situations in the fragile states to strengthen the health system as well as foster development of people. Establishment of a package that supports combination of sophisticated healthcare services can be regarded as another important element within the Health Systems Strengthening, which is capable of reaching out to the needy people in search of healthcare amenities. Continuity in supply of medications can be treated as another important element associated with improvement of healthcare amongst people residing in fragile states. The best example of this can be the issues associated with child-malnutrition as can be observed in sub-Saharan African nations of Ethiopia and Niger, where every year, several people die owing to the high levels of poverty. Moreover, there is a need to focus on human resource for rebuilding health in fragile states. Human Resources are associated with development of medical services and facilitating the same in fragile nations through recruitment, selection and training of staff (Ramin 886). Financial services that are catered by public as well as ‘Non Government Organizations’ (NGO) are aimed towards ensuring that the medical services are being provided to the people in fragile states also serves as an important element of Health Systems Strengthening. Moreover, to ensure improvement of healthcare services, finance must be procured with the help of joint collaborations with the NGO’s, since they carry a higher degree of knowledge regarding the prevailing scenario. Flexibility in financing can be considered as an important aspect associated with procuring finance since it ensures that people facing health issues have the opportunity to continue in medical aid. In this regard, coordination amongst the donors can be considered as an important aspect of health system strengthening, since it ensures that medical facilities are being appropriately catered amongst the public living in fragile nations (Ramin 886). In terms of urbanization dynamics, comprising of factors such as spread of diseases, sanitation levels, waste management, child mortality, income of people and composition of people living in rural and urban areas, it is worth mentioning that the there exists several differences underlying such factors in case a comparison is made between two fragile nations. Some of the nations that have been associated with constant growth in urbanization are Kenya and Niger and have been recognized across the globe as fragile states. In Kenya, the existence of high rates of child mortality in the urban locations, particularly in the slums, wherein the rate of child mortality is 2.5 times higher in comparison to other locations of the nation. This has been a result of increasing pressure on urban areas. Although people in Kenya are shifting towards urbanization, however, they are unable to ensure fulfillment of basic amenities such as sanitation and waste management. Another fragile nation, which has been facing numerous problems associated with urbanization dynamics is Niger. In Niger, owing to high rates of urbanization and construction of slums, child malnutrition has become a common problem, which is considered as an important aspect associated with urban dwelling. Moreover, 40% of the children dwelling in urban slums health issues associated with child malnutrition. Additionally, in Niger, the percentage of immunization amongst people living in urban slums is restricted to 35%, in comparison to non-slum locations having 86% immunization cover. This reveals an increasing rate of negative impact on the health of people, owing to high rate of construction of slums and migration of people in urban areas. Nations such as Papua New Guinea and New Zealand are also facing increased risks associated with chronic illness and health problems, owing to high rate of urbanization. Furthermore, findings elaborate the fact that there will be an increase in the urban population by 72% by the end of 2030, which would be harmful for urban dwellers, especially for those living in urban slums (Rydin, Bleahu, Davies, Dávila, Friel, Grandis, Groce, Hallal, Hamilton, Howden-Chapman, Lai, Lim, Martins, Osrin, Ridley, Scott, Taylor, Wilkinson and Wilson 2088-2096). HEALTH SERVICES Health services are associated with fostering medical aid and healthcare among the people who are linked with health-related issues residing in fragile states. In this context, people belonging to fragile states do not carry adequate resources to rebuild their health issues, and hence rely on various private as well as government institutions for securing a better life and ensuring depletion of healthcare issues. In this regard, it is the prime responsibility of such organizations to ensure that the health services are being provided to the patients and they are continuously being reviewed in terms of their health standards. Hence, rebuilding of health services aims at providing healthcare facilities to the people, thereby, enhancing the role of health system strengthening in fragile states. Health service involve the development of servicers such as medical aid, campaigns, medical staff, quality of precautions and medications used, apart from enhancing the level of hospitality of patients suffering healthcare problems in fragile nations (Ramin 886). HEALTH SYSTEMS Similar to rebuilding of health services, health systems are associated with successive development and facilitation of healthcare services, however, on a larger scale. More specifically, rebuilding health systems aim towards development of a successive framework based on which the services are provided to people in fragile states to deal with healthcare issues. Rebuilding health systems play an important role in contributing towards re-building of fragile states and further acts as a phenomenon that supports reduction of health issues of people residing in the state in a responsible manner. Rebuilding health systems play an important role in ensuring enhanced degree of support, thereby resulting in the development of a successive understanding and cooperation amongst the fragile states and the society. In addition, health systems play an important role in ensuring appropriate deliverance of healthcare services throughout the fragile state and appreciation of building and strengthening healthcare capacities beyond the healthcare segment (Shope “Impacts of Global Climate Change on Human Health”). QUESTION 2 Thesis statement. The question aims at identifying the factors associated with good governance system and their role in eliminating issues pertaining to healthcare. The governance structure existing in plays an important role in determining the success or failure of the healthcare strengthening system undertaken in order to boost the level of healthcare development amongst the people. A good governance system enables information delivery and further strengthens the ability of citizen towards ensuring their participation and voice. A good governance system allows the development of several healthcare services and further ensures that the healthcare issues are mitigated to the lowest possible extent. Moreover, there is a need to understand the fact that ‘Good’ governance leads to the development of ‘good’ policies that in turn ensures that there exists stability in operations associated with providing medical services to people. In addition, there is a need to concentrate on the importance of good governance in maintaining social equality and ensuring empowerment of people. Additionally, a good governance structure further ensures that there exists continuity in the flow of aid and finance, which further helps in carrying out the healthcare support activities effectively. Concerning healthcare issues, a good governance structure further ensures that the steps being taken by the government as well as private institutions towards ensuring better medication facilities (Shope “Impacts of Global Climate Change on Human Health”). In relation to health-related problems, there is a need to consider the importance a good governance structure that facilitates decision-making in relation to mitigation of health issues and further helps in eliminating the same. Additionally, there is a need to concentrate on the fact that a proper governance structure also ensures development as well as implementation of effective steps with respect to healthcare problems faced by people. A good governance structure can facilitate the development of immunization as a way of facilitating promotion and coping with the health-related problems. Immunization is necessary as part of a good governance structure, which helps in improving the existing rate of immunization in the nation. A good governance structure facilitates deliverance of immunization amongst people since they are associated with coopering with several private as well as public NGO and seek their participation in several immunization programs launched by good governance structures. In addition to the aforementioned factors, a good governance structure ensures that people facing health-related issues are further protected from healthcare problems. Governance of a nation can facilitate immunization by providing education to people on hygiene, apart from raising awareness regarding the use of mosquito nets to ensure that the immunization is effective. In addition to the aforementioned factors, Shope suggested that appropriate governance structure further helps in avoiding the ill consequences of poor health by focusing on the development of people and further ensures that the health issues are being considered effectively. Moreover, there is a need to consider the fact that apart from facilitating medical aid amongst people through immunization, a good governance system aims towards mitigating the health issue of policy discrimination (Shope “Impacts of Global Climate Change on Human Health”). Several policies have been launched by NGOs and public healthcare organizations across the globe, which plays a key role in enhancing the rebuilding and development of healthcare systems, thereby fostering the success of undertaken healthcare project. Strong governance plays crucial role in highlighting the importance of mitigating ill health by ensuring that policies design in association with the same are able to address the needs of the people. Moreover, positive governance ensures that the policies associated with facilitating healthcare services and rebuilding of the health system are duly adhered as per the pre-determined guidelines. Additionally, there is a need to consider the fact that good governance plays a key role in fostering participation of citizens in improving healthcare facilities, which further helps in demoralizing discrimination of the policies associated with rebuilding of the healthcare systems (Rapley 2-3). For gaining an understanding of the positive effects of having a good governance structure and its association with mitigating healthcare-related issues, the article “Floods, health and climate change: a strategic review” by Few & Roger, Ahern, Matthies and Kovats (2004) was selected. The article provides an overview of the need to launch an appropriate governance structure that facilitates the need to provide immunization to people in order to ensure that they are able to cope with the health-related issues. Moreover, the article provides an in-depth understanding of the importance of a ‘good’ governance structure and role of the same in ensuring development of health-affected people through prioritizing enactment of policies (Few, Roger, Ahern, Matthies and Kovats 50-65). One of the prime examples associated with reduction of healthcare services is the development of bad governance policies, as observed in African nations such as Uganda and Mozambique. Moreover, such situations can be recently observed in South-East Asian nations such as Bangladesh and Pakistan, wherein, existence of bad governance structure can lead to emergence of several health issues. Additionally, issues associated with fall in GDP and prevalence of poor health has resulted increased risks and vulnerability, which in turn has created adverse impact on the growth and development of nation, thereby increasing situations of illness. QUESTION 3 Thesis Statement. The aim of this question is to focus on highlighting how climate change might have an affect over chronic poverty, in the context of health and nutrition. Climate changes are considered as natural phenomena; however, they might also result from occurrence of certain harmful and artificial factors. Climatic changes are noticed at times when there are changes in the proportion of atmospheric gases, which might result in the development of several ill effects on the people. Moreover, climatic changes can also have significant impact on the health-related issues, which might be supported by the common issues such as chronic poverty and malnutrition amongst people. In the context of health and nutrition, climate changes play a major role in the development of health-related problems, by increasing the number of diseases associated with changes in climate. A higher degree of climatic changes can have negative consequences on people and might lead to development of outcomes such as high rates of mortality and injuries amongst people. In addition, climatic changes, such as droughts and floods, can result in development of epidemics and further might cause widespread of diseases such as Cholera, Malaria, Rotavirus and Diarrhea. One of the prime examples of this situation is the existence of malnutrition and situations of droughts and floods that take place in African nations of Ethiopia and Mozambique. Climate changes are also associated with outdoor pollution, which can lead to mass deaths, an example of which can be the 49,000 premature deaths in Africa on a yearly basis. Moreover, in acute situations, climate changes might result in starvation and death of people, owing to food shortages, which might further have a negative impact on the mental health and well-being of people. In addition to climatic changes, natural disasters can also play a crucial role in deteriorating the performance of medical healthcare delivery, which further can create a negative influence over the six building blocks of the healthcare mechanism. Situations underlying chronic poverty might further result in deterioration of the six building blocks associated with health systems (Rapley 2-3). In the context of climatic changes chronic poverty can also be measured in terms of different factors including nutrition, income, consumption as well as indicators of overall expenditures. In this regard it can be stated that nutritional status along with expenditure limit of the individual are likely to affect the condition of poverty. However, it has been further argued that the nutrition policies serve as an indicator of chronic poverty (Hulme, David and Shepherd 405-407). One of the building blocks associated with health is the governance structure, which might be hampered owing to climate changes and might limit the deliverance of services to the people. In addition, the building block comprising of the ‘healthcare financing’ might also be affected because of climate change, due to which the people might be unable to gain access to healthcare amenities. Moreover, due to climate changes, the workforces associated with facilitating healthcare services might not be able to perform their job role effectively, which can further increase negative consequences on the health-related aspects of people. Similarly, another important aspect of healthcare system, i.e., service delivery might also be disrupted owing to climatic changes, which may result in increase in the number of people associated with ill health. Climatic changes might also hamper the development and sharing of information regarding health-related aspects, which might reduce the effectiveness of the information shared and the development of healthcare services (Hulme, David and Shepherd 410-420). In addition to the above-mentioned factors, rebuilding and development of the healthcare frameworks might also be impeded due to natural disasters of droughts and floods, which carry a number of diseases with them and can certainly play an important role in increasing mortality rates. In the context of increasing healthcare issues, disease outbreak might further create mental burden amongst people, which would result in increased mortality rates and might further disorders associated with health-related issues. Moreover, empirical evidence suggests that Rift Valley fever and Dengue might also occur because of climatic changes and the treatment of which can require substantial efforts to cope with the situation. Additionally, there is a need to notice the importance of interventions by the human resources facilitating healthcare treatment, which might further have a positive effect on the development of substantial understanding of the elimination of healthcare services problems. Hazards and natural disasters can have a substantial impact on chronic poverty, since they pose a direct threat to the people and might further deteriorate the development of healthcare services. This in turn is likely to cause difficulties for the service provider to deliver proper medical aid in time (Salama, Peter, Spiegel, Talley and Waldman 1804-1806). There is a need to lay strong emphasis on the fact that climate changes can have adverse affects on the health and well-being of people, since they might lead to the outbreak of infectious diseases. In addition, situations of flood and draught, apart from leading to mental pressure, can also act as a major component in the enhancement of chronic poverty. Chronic poverty can be mostly be observed in slums, wherein natural disasters can have a negative impact on the people dwelling in slums and can increase the rate of child mortality, as observed in Mozambique and other African nations. Moreover, immunization coverage can also be hampered owing to the increase in the level of diseases associated with chronic poverty such as locations having high population density might be prone to epidemic infections (Labrecque 18-21). An important aspect of natural disasters on the development of ill health is that it can lead to urbanization. A prominent example of the fall of healthcare amongst people owing to natural disasters is the development of healthcare problems amongst people residing in Latin American nations, wherein, natural disasters are a common phenomenon are a major cause behind the emergence of health-related issues such as poverty and spread of diseases. Since a majority of the population, such as Nigeria and some other African nations is dwelling in slums located in rural areas, the people would be forced to leave their homes and move towards locating themselves in city. Moreover, climate changes have resulted in increased urbanization and movement of people to urban areas, owing to availability of medication and aid facilities. A high rate of transfer of people from one location to another can result in increased pressures on people already residing in urban areas and can further make them prone to several diseases shared by people belonging to rural areas. Additionally, the increased rate of urbanization may also be a result of floods and drought, which might require people to search for new areas of inhibition. However, the transfer of people and increase in the rates of urbanization may not act as an aid since people shifting towards urban areas tend to establish slums in areas that might incorporate adverse health effects because of lack of basic healthcare amenities, such as sanitation. Moreover, unpredictable interaction between the climatic changes and urbanization would enhance the rate of migration, which might further result in increased stress on the urban development and infrastructural facilities. Hence, there is an urgency to develop several interventions to tackle chronic poverty, which would only be possible through gaining a comprehensive understanding of the relationship underlying climate change and urbanization (Prüss-Üstün and Corvalán 10-14). Works Cited Commins, Stephen. “Non-State Providers, the State, and Health in Post-Conflict Fragile States”. Development in Practice 2010: 594-602. Print. Few, Roger, Mike Ahern, Franziska Matthies and Sari Kovats. “Floods, health and climate change: a strategic review Roger”. Working Paper 63 2004: 1-122. Print. Hulme, David and Andrew Shepherd. “Conceptualizing Chronic Poverty.” World Development 2003: 403-423. Print. Labrecque, Guillaume. “Local Accountability in Service Delivery - The Tuungane Community Scorecard Approach”. Governance and Rights Briefing Paper 2014: 1-27. Print. Prüss-Üstün, A. and C. Corvalán. “Preventing Disease through Healthy Environments.” Executive Summary 2006: 1-16. Print. Ramin, Brodie. “Slums, climate change and human health in sub-Saharan Africa.” Bull World Health Organ 2009: 886. Print. Rapley, Chris. “The health impacts of climate change.” BMJ 2012: 1-4. Print. Rydin, Yvonne, Ana Bleahu, Michael Davies, Julio D Dávila, Sharon Friel, Giovanni De Grandis, Nora Groce, Pedro C Hallal, Ian Hamilton, Philippa Howden-Chapman, Ka-Man Lai, C J Lim, Juliana Martins, David Osrin, Ian Ridley, Ian Scott, Myfanwy Taylor, Paul Wilkinson and James Wilson. “Shaping cities for health: complexity and the planning of urban environments in the 21st century.” The Lancet 2012: 2079-2108. Salama, Peter, Paul Spiegel, Leisel Talley and Ronald Waldman. “Lessons Learned From Complex Emergencies Over Past Decade.” Lancet 2004: 1801–1813. Print. Shope, Robert E. “Impacts of Global Climate Change on Human Health.” Spread of Infectious Disease. 1992. Web. 6 Jun 2015. Read More