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Health system development & National health policy
The document outlines the definitions and models of health systems, emphasizing the significance of national health policy in public health. It describes various health care models, including the Beveridge, Bismarck, national health insurance, and out-of-pocket models, while highlighting Ghana's health system development efforts towards universal health coverage. Additionally, it stresses the role of health policy in addressing environmental health challenges and improving overall health and economic productivity in Ghana.
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Introduction to primary health care, health system development, and the importance of national health policy.
Different health care system models: Beveridge, Bismarck, National Health Insurance, and Out-of-Pocket.
Global ambitions for universal health coverage by 2030 and the challenges faced in Ghana.
Overview of health service delivery structures and the integration of services at various levels.
Definition of health policy, its objectives, and various categories of health policies.
Ghana's National Health Policy focus on socio-economic development and health promotion goals.
Importance of health in economic growth and the adage 'a healthy population is a wealthy population'.
Discussion of environmental health challenges in Ghana and the need for national health policy interventions.
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Health system development & National health policy
- 1. PRIMARY HEALTH CARE (EHT106) SIR OAK (ACCRA SCHOOL OF HYGIENE)
- 2. LECTURE EIGHT Health systemdevelopment & National health policy
- 3. Learning objective: After completingthis topic, students are expected to: • explain the term health system; • identify the models of health care system; • describe the development and delivery of health care systems; • explain the essence of national health policy in addressing issues of public health.
- 4. Introduction • A healthsystem, also sometimes referred to as health care system, is the organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations. • Health systems are responsible for delivering services that improve, maintain or restore the health of individuals and their communities. • Common elements in virtually all health systems are primary healthcare and public health measures.
- 5. Models of healthcare systems 1. The Beveridge Model • Named after William Beveridge, the social reformer who designed Britain’s National Health Service. • In this system, health care is provided and financed by the government through tax payments. • The system tend to have low costs per capita, because the government, as the sole payer, controls what doctors can do and what they can charge. • Countries using the Beveridge model include Great Britain, Spain, most of Scandinavia and New Zealand.
- 6. Models of healthcare systems cont… 2. The Bismarck Model • Named for the Prussian Chancellor Otto von Bismarck, who invented the welfare state as part of the unification of Germany in the 19th century. • It uses an insurance system — the insurers are called “sickness funds” — usually financed jointly by employers and employees through payroll deduction. • The Bismarck model is found in Germany, France, Belgium, the Netherlands, Japan, Switzerland, and, to a degree, in Latin America.
- 7. Models of healthcare systems cont… 3. The National Health Insurance Model • This system uses private-sector providers, but payment comes from a government-run insurance program that every citizen pays into. • The single payer tends to have considerable market power to negotiate for lower prices. • National Health Insurance plans also control costs by limiting the medical services they will pay for, or by making patients wait to be treated. • The classic NHI system is found in Canada, Taiwan and South Korea
- 8. Models of healthcare systems cont… 4. The Out-of-Pocket Model • The developed or industrialized countries (perhaps 40% of the world’s countries) have established health care systems. • Most of the nations on the planet are too poor and too disorganized to provide any kind of mass medical care. • The basic rule in such countries is that the rich get medical care; the poor stay sick or die. • In rural regions of Africa, India, China and South America, hundreds of millions of people go their whole lives without ever seeing a doctor.
- 9. Development of healthsystem • There’s a global ambition to achieve universal health coverage and health equity by the year 2030. • SDG 3 aims to ensure healthy lives and promote well-being for all, at all ages. • There is increasing interest in access to and utilization of PHC in low- and middle-income countries. • The quality of health care system is expressed through coverage, access, equity, efficiency in use of resources, and financing.
- 10. Development of healthsystem cont… • Health care system infrastructure includes: services, facilities, institutions/establishments and organizations. • The health care system in Ghana has a formidable task of improving and guaranteeing the health and well-being of Ghanaians. • The health system has the responsibility of combating illnesses associated with poverty and lack of education; at the same time, it has to deal with a growing population, inadequate funding and resources.
- 11. Structure of deliveryof services. • As a result of decentralization and health sector reform, services are integrated as one goes down the hierarchy of health structure from the national to the sub-district. • The Regional Health Administration provides supervision and management support to the districts and sub-districts within each region. • At the regional level, curative services are delivered at the regional hospitals. • The public health division of the Regional Hospital as well as the District Health Management Team (DHMT) deliver public health services.
- 12. Structure of deliveryof services cont... • The District Health Administration provides supervision and management support to the sub-districts. • At the district level, curative services are provided by district hospitals, many of which are mission based. • Public health services are delivered by the DHMT and the public health unit of the district hospitals. • At the sub-district level, both preventive and curative services are provided by the health centers, as well as outreach services to the communities within their catchment areas. • The role played by the traditional birth attendants (TBAs) and the traditional healers is also receiving national recognition.
- 13.
- 14. National Health Policy •Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society. • An explicit health policy can achieve several things: it defines a vision for the future; it outlines priorities and the expected roles of different groups; and it builds consensus and informs people. • Categories of health policies include: global health policy, public health policy, mental health policy, health care services policy, insurance policy, vaccination policy and breastfeeding promotion policy.
- 15. National Health Policycont… • In 2007, the National Health Policy was designed within the context of Ghana's vision of achieving middle income status by 2015. • It places health at the center of socio-economic development and presents a clear shift in the role of health in the national and international development framework. • This is based on the recognition that health is not only a human right issue, but also a key driver of development, and ultimately of wealth creation. • Globalization is facilitating the transfer of goods, services, people, values and lifestyles from one country to another. Hence, policies of one country affect another country.
- 16. National Health Policycont… • The mission of the MoH as stated in the policy document is to contribute to socio-economic development and wealth creation by: promoting health and vitality, ensuring access to quality health, population and nutrition services for all people living in Ghana and promoting the development of a local health industry. • This mission puts the concept of health beyond the confines of curative care to other socio-economic determinants of health.
- 17. PHC as thebasis for National Health Policy • The theme of the Ghana’s Health Policy is “Creating Wealth through Health”. • The strategic direction of improving human capital makes health central to Ghana's development efforts. • Only a healthy population can bring about improved productivity and subsequent increase in GDP, and by doing so ensure economic growth. • Hence, the old adage “a healthy population is a wealthy population”
- 18. Class Exercise Suggest five(5) environmental health challenges that require National Health Policy intervention to address.
- 19. Why National HealthPolicy? • In fact, the poor environmental conditions in which Ghanaians live, work and go to school has a major impact on their wellbeing. • The poor air, water and soil quality in the country is mainly due to improper disposal of waste, emission of dangerous gases from industries and vehicles, and smoke from burning of waste and bush fires. • Only a third of the waste produced in the urban centers is collected leaving the rest to pollute the environment. • Less than half of the population in the country has access to potable water, leaving the rest to obtain water from streams and rivers, which are often contaminated.
- 20. Why National HealthPolicy cont… • Our poor lifestyle, together with known environmental factors, most of which are preventable, manifest in a high level of morbidity and mortality in the country. • Resource limitations and budget constraints call for participatory health policy planning to ensure equitable and balanced distribution of health facilities, projects and interventions.
- 21. Why National HealthPolicy cont… • The policy argues that the disease profile and mortality patterns of the country are directly linked to: improvements in environmental hygiene and sanitation proper housing and town planning provision of safe water provision of safe food and nutrition encouragement of regular physical exercise improvements in personal hygiene immunization of mothers and children prevention of injuries in our work places prevention of road accidents practicing of safe sex.
- 22.