module 5 emergencies and the health systems. module 5 hospital system health system epidemiology and...
TRANSCRIPT
Module 5
HospitalSystem
Health System
Epidemiology andSurveillance
Prevention and Control of Communicable Disease
Food and Water andNutrition Sanitation
Preparedness
Response
Recovery
Health System
Module 5
ObjectivesAt the end of this 1-hour session, the participants
will be able to:Define and discuss the building blocks of the health
systemDiscuss how emergencies/disasters disrupt the
existing health systemDescribe health emergency response using the
health systems approach
Module 5
Emergency
Health system
Evacuation centres Security Nutrition Surveillance Disease prevention and control Logistics Information Management Resource Mobilization Risk Communication
Save lives
Module 5
The Health SystemA health system consists of all organizations,
people and actions whose primary intent is to promote, restore or maintain health
Includes efforts to influence determinants of health as well as more direct health-improving activities
IncludesA mother caring for a sick child at homePrivate care providersBehaviour change programmesVector-control campaignsHealth insurance organizationsOccupational health and safety legislation Inter-sectoral action by health staff
Module 5
The WHO Health Systems Framework
System building blocks Goals/outcomes
Service delivery
Health workforce
Information
Medical products & technologies
Health financing
Leadership/ governance
Improved health
(level and quality)
Responsiveness
Financial risk protection
Improved efficiency
Access coverage
Quality safety
Module 5
The WHO Health Systems Building BlocksService delivery
Health workforce
Information
Medical products and technologies
Health financing
Leadership/governance
Module 5
The WHO Health Systems Building BlocksService delivery
Effective, safe, quality personal and non-personal health interventions to those who need them, when and where needed, with minimum waste of resources
Health workforce Responsive, fair and efficient to achieve the best health
outcomes possible, given available resources and circumstances
Sufficient numbers and mix of staff, fairly distributed Competent, responsive and productive.
Information ensures the production, analysis, dissemination and use
of reliable and timely information on health determinants, health systems performance and health status
Module 5
The WHO Health Systems Building BlocksMedical products and technologies
Equitable access to essential medical products, vaccines and technology
Assured quality, safety, efficacy and cost-effectiveness, and their scientifically sound and cost-effective use
Health financing Adequate funds for health, in ways that ensure people
can use needed services, and are protected from financial catastrophe or impoverishment associated with having to pay for them
Leadership/governance Existence of strategic policy frameworks that are
combined with effective oversight, coalition-building, the provision of appropriate regulations and incentives, attention to system-design, and accountability
Module 5
Health Systems in EmergenciesEmergencies/disasters affect the health system
Consideration for assessment, planning and implementation of response
Response, reconstruction and preparedness phases
Module 5
How do disasters affect the health system?
Socio-political context
Environmental context
Economic context
Community lifelines: water, electricity,
transportation
6 Building Blocks of the Health System:
Health services
Health Workforce
Health Information
Medical Products and Technologies
Health Financing
Health Governance
Health
Source: Informal discussion with Dr R Lejano, UC Irvine, 2009
Module 5Activity 3: How emergencies/disasters affect the health system
Divide into 3 groups
Discuss on how disasters can affect the building blocks of the health system,Group A: Service delivery, health workforceGroup B: Information, medical products and
technologiesGroup C: Health financing, leadership/ governance
List down salient points and discuss with the group
Module 5
Activity 3: ResultsService delivery
Health workforce
Information
Medical products and technologies
Health financing
Leadership/governance
Module 5
How disasters affect the health systemService delivery
Medical & surgical services: outpatient and inpatient care
Public health services: immunization, health promotion, reproductive health, environmental health, maternal and child health
Health workforceDirect and indirect impact to health professionals
and their familiesSame number of staff to work on increased
demandSafety, security & psychosocial support
Module 5
How disasters affect the health systemInformation
Information system breakdownNeed for rapid information
Medical products and technologiesDamages and losses Increased demand for medical products and
technologies
Module 5
How disasters affect the health systemHealth financing
Direct and indirect economic losses Increased demand for expenditureResponse require faster resource/finance
mobilization mechanisms
Leadership/governance Increased demand for quick decision makingShift to emergency mode Influx of external agencies, NGOs and groups
Module 5
WPRO Health Systems Assessment Tool
WHO/WPRO, 2009(Lejano, Sablan, et al)
Tool developed for assessment of the health systems in order to aid health emergency planners and policy makers for medium-
and longer- term decisions.Questions are answerable by YES or NO.
Module 5
WPRO Health Systems Assessment ToolService delivery
Are there health facility structures/buildings and/or key equipment within them that have been damaged by the disaster?
Are there support systems that have been damaged by the disaster?
Are there health services/programs that have been compromised by the disaster?
Module 5
WPRO Health Systems Assessment ToolHealth workforce
Did staff complement/ number of personnel reporting for work become a problem in the adequate carrying out of emergency response and recovery measures?
Did staff knowledge and skills become a problem in the adequate carrying out of emergency response and recovery measures?
Were the members of the hospital staff affected by disrupted lifelines (i.e., communication, transportation, shelter)?
Module 5
WPRO Health Systems Assessment ToolInformation
Are there concerns regarding health information systems concerning individuals as patients?
Are there concerns regarding health information systems on health facilities?
Are there concerns regarding health information on the general population?
Are there concerns regarding health information concerned with public health?
Module 5
WPRO Health Systems Assessment ToolMedical products and technologies
Is there adequate supply of essential drugs in the health facilities? Are these readily available and affordable?
Are there concerns regarding quality of the drugs/vaccines available in the health facilities and pharmacies?
Are there concerns regarding availability, safety and accessibility of blood transfusion services in the health facilities?
Are there concerns regarding the availability of hospital equipment necessary for the basic surgical, anesthetic, medical and emergency care appropriate for the level of service a health facility offers?
Are there concerns regarding safety, reliability and availability of diagnostic and laboratory technology services in the area?
Are there concerns regarding safety, reliability and availability of diagnostic and imaging services in the area?
Module 5
WPRO Health Systems Assessment ToolHealth financing
Did the disaster affect (increased, decreased, scrapped) the revenue, government funding, and expenses of the health facilities in the subject area?
Was funding of health programs affected (increased, decreased, scrapped) by the disaster?
Module 5
WPRO Health Systems Assessment ToolLeadership/governance
Did the disaster reveal any major issues in how emergencies are responded to, in how tasks and funds are allocated during emergencies, and how decisions are made during emergencies?
Did the government and other agency response to the disaster divert from and possibly change the way decision-making, allocation of funds, and allocation of tasks among agencies are made during an emergency?